Check or Credit Card Donation Form

Please print out the following form and mail to the FVPF.

FAMILY VIOLENCE PREVENTION FUND
383 RHODE ISLAND STREET, SUITE 304
SAN FRANCISCO, CA 94103

Name ____________________________________________________

Address __________________________________________________

City_______________________ State _____ Zip ______________

Day phone: _______________________ Evening Phone: __________________

Fax: _____________________ E-Mail ____________________

YES! I want to make a donation of:

_____ $25- will help FVPF make a local neighborhood a domestic violence free zone with the “Neighbor to Neighbor” action kit.
_____ $50 - will help the FVPF distribute domestic violence awareness posters in more than a dozen public locations.
_____ $100 - will help the FVPF disseminate 1,000 Victim Safety Cards throughout the country.
_____ $500 - will help the FVPF print and distribute 1,000 bumper stickers which say, "THERE'S NO EXCUSE FOR DOMESTIC VIOLENCE".
_____ $1,000 - will help the FVPF educate ten corporations on how to support battered women at work.
_____ $2,500 - will help the FVPF train hundreds of judges on how to better handle domestic violence cases.
_____ $5,000 - will help FVPF train staff at ten hospitals on how to recognize and help battered women.
_____ $10,000 or more - will help the FVPF develop an education campaign aimed at getting men involved in stopping family violence.
Other ____________

This gift is in honor of_____________________________

_____ I want to give by check. Check enclosed.

Please charge my (circle one): Visa   Master Card

Credit card account no.: __________________________ Expiration date: __________

Signature: ___________________________

_____ Please send me more information about the FVPF's work.

NOTE: If you would like to make a donation of goods or services, or volunteer your time, please contact your State Domestic Violence Coalition for the names and phone numbers of domestic violence programs in your area. The National Coalition Against Domestic Violence provides a complete list of state resources.