Donation Form

American Friends of Belize

Last Name (print) ______________________________  First Name ________________________________

Street Address _________________________________________________________________________

City _____________________________________  State ___________  Zip Code ____________________

Donation Amount

$10,000    $5,000   $2,500   $1,000   $500   $250   $100   $50     Other $______________

Payment

Enclosed is my check payable to "American Friends of Belize" for $_____________________

Credit Card: (circle one)     Master Card       Visa       Amount:  $_________________________

Card number: ___________________________________________  Expiration Date__________

Name on Card______________________________________________  

Signature__________________________________________________

All credit cards will be processed through JustGive.org.

Use of Donation (circle one)

TIDE                     Liberty Children's Home                 Humanitarian Aid              General Expenses   

Please Send Form To:

American Friends of Belize, P.O. Box 850053, Mobile, AL  36685-0053.  A receipt for your donation will be provided in the return mail.

Questions?  Please email our office:  info ["at" symbol] americanfriendsofbelize.org

The American Friends of Belize is a charitable organization under Section 501(c)(3) of the Internal Revenue Service of the United States.  U.S. Federal Tax I.D. #36-4517663.