|

|
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 |