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Alpha Pregnancy Resource Center
Individual Contribution
Yes, I want to work with Alpha Pregnancy Resource Center to help people in unplanned
pregnancies!
Please print this page and mail to: Alpha Pregnancy Resource Center
13845 Highway 13 South
Savage, MN 55378
Name: ______________________________________________________________________________
Address: ___________________________________________________________________________
City: ___________________________________________ State: ________ Zip: _____________
Email: _____________________________________________________________________________
We will help through a (circle one): One time gift Monthly Support Commitment
Enclosed is my gift of: ___ $50 ___ $100 ___ $250 ___ $500 ___ $1,000 or $________
Please charge my (circle one): Visa Master Card Discover or American Express
Account #: _____________________________________ Expiration Date: ________________
Signature: _______________________________________________________________________
As required by current tax laws, Alpha Pregnancy Resource Center acknowledges that
nothing has been given in return for this contribution. Your gift is 100% tax
deductible. Thank you for enabling us to meet the needs of those in our area.
Please send information about Alpha Pregnancy Resource Center to my friends:
Name: ______________________________________________________________________________
Address: ___________________________________________________________________________
City: ___________________________________________ State: ________ Zip: _____________
Name: ______________________________________________________________________________
Address: ___________________________________________________________________________
City: ___________________________________________ State: ________ Zip: _____________
This form printed via the internet at www.alphaprc.com