Please print this page and, after filling it out, mail it to:
Disability Rights Education & Defense Fund
3075 Adeline Street, Suite 210
Berkeley, CA 94703
I believe that individuals with disabilities have the right to an education, transportation, housing, and access to public services as well as the right to lead independent, dignified, and enjoyable lives. I want to make a difference to ensure that people with disabilities continue to have these rights.
Here is my tax-deductible gift to DREDF in the amount of $__________.
I’d like to make a recurring donation in the amount of $__________ every month/quarter. (Please circle one.)
Name (As on credit card, if applicable): _________________________________________________
Address: ________________________________________________________
City: ________________________________ State: ____ Zip: _______________
Phone: __________________________ Email: ______________________________
About your contribution:
_____ My check payable to DREDF is enclosed.
_____ Please charge my: MasterCard Visa American Express
Card No. _______________________________________________
exp. date ______________________________________________
3-digit security code __________________________________
Billing zip code _______________________________________
Signature ______________________________________________
Gifts made in recognition:
_____ In Honor ____ Memory of ___________________________________________
Please send a gift notification to:
Name: __________________________________________________________
Address: _______________________________________________________
City: ________________________________ State: ____ Zip: ___________
Thank you!