Donation Mail-in Form
Mail to: PFOX, P O Box 510, Reedville, VA 22539
______ I would also like to volunteer for PFOX
Option A: One-time donation
Enclosed is my check for $_______ made payable to PFOX. All donations are tax-deductible.
Option B: Monthly donation by credit card
Please charge my credit card on a monthly basis in the amount of $
Visa _______ MasterCard _______
Account # ____________________________________
Expiration Date: ____/____/____
Option C: Monthly donation by automatic bank payment
I hereby authorize Parents and Friends of Ex-Gays, Inc. (PFOX) to initiate debit entries to my bank account at the bank named below. I understand that my bank will transfer directly from my bank account to PFOX the amount I have designated below:Bank Name: _________________________________________
City, State & Zip Code: __________________________________
Account Number: ___________________________
(Attach a voided check to this form)
Amount to be debited from your bank account
each month: $_________________
This authorization is to remain in effect until PFOX has received written notification from me of its termination and in such time as to afford PFOX and my bank a reasonable time to act on it. A record of my payment will be included in my regular bank statement and will serve as my receipt.
Donor Name: _____________________________________
Option D: Other donations
Frequent Flyer Miles Needed: Please donate your frequent flyer miles to PFOX. With all the traveling we do, we can use them!
Matching Gifts: There are more than 5,000 companies that match employee gifts made to nonprofit organizations like PFOX. Contact your employer's Human Resources office to ask if your company has a matching gift program. If it does, obtain a Matching Gift Form from your Human Resources office. Make your check payable to PFOX. Mail your check with the Matching Gift Form to PFOX.
Option E: Donation of stock
Donors can use securities to support PFOX. You can donate shares without having to pay capital gains tax on those shares and still write off the full current value of the shares. Please have your stockbroker notify us of the following information:
- Brokerage name
- Name and type of company stock
- Number of shares to be donated
- Current price per share (at the time of transfer)
- Date of transfer to PFOX