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DONATION FORM

(Please print out this form and mail with your donation):

Attn: Louisa Brady, Development Manager
The International Center in New York
50 West 23rd Street, 7th Floor New York, NY 10010-5205

Telephone: 212-255-0145
FAX: 212-255-0177

Name______________________________________________

Address____________________________________________

City_______________ State____ Zip___________________

Home Phone___________________ Work Phone________________

E-mail________________________

I am enclosing a tax-deductible contribution to The International Center in New York for the amount of $_____________.

___Check Enclosed

___MasterCard   ___Visa   ___American Express

  Card #:______________________________________

  Name on Card: ________________________________   Expiration Date: __/__/__

  Signature x______________________________________________

___I would like to make a gift of appreciated stock.
___I will ask my employer to match my gift
    Company Name:_____________________
___I'm interested in volunteering.
___Please allocate this gift to the Scholarship Program.
___This donation is for the Sponsor an Immigrant campaign.

The International Center in New York, Inc. is a not-for-profit 501©3 organization. 100% of your contribution is tax-deductible. A copy of the latest annual report can be obtained from The International Center in New York or the New York State, Office of the Attorney General, Charities Bureau, 120 Broadway, New York, NY 10271.