Please give to the Disability Law Center

Print this form

Enclosed, please find my tax-deductible gift to help support advocacy work done by the Disability Law Center :

 

____ $250    ____ $200    ____ $150    ____ $100    ____ $50     ____  Other $__________   

_____  Check Enclosed      _________   Donation by Credit Card

Credit Card Information:            ____ VISA    ____ MasterCard   ____  AMEX    ____  Discover

 



 Card #  Expires 
Signature  X  ___________________________________________

  


Name

 


Address

 


City / State / Zip

 


 
Email 

q Please add me to your e-mail list.

 

 

Thank You!

For giving to the Disability Law Center. We are the protection and advocacy agency for the state of Massachusetts and the only agency that represents any person with any disability. With your help, we are able to continue to provide free and affective legal services to our clients.

 

Mail to:

Disability Law Center, Inc.
11 Beacon Street, Suite 925
Boston, MA 02108

Tax ID# 02-2741869