NEW YORK BRANCH

MAKE A SAFE & SECURE DONATION ONLINE

Your tax – deductible donation will make a difference to the thousands of children and individuals with dyslexia and related learning disabilities that benefit from IDA-NY’s programs & services.


Donation Amount: (US Dollars)
GIFT INFORMATION:
I'd like to make this donation	on behalf in memory of
Please send acknowledgement of this gift to:	(email address)
YOUR NAME AND BILLING ADDRESS BELOW
First Name:
Last Name:
Address1:
Address2:
City:
State:
Zip/Postal Code:
Country:
Phone:	(area code)
E-mail:


PAYMENT METHOD	Name on Card :
	Credit Card Type:
	Credit Card Number:
	Expiration Date:

Anonymous Donation	I prefer to make this donation anonymous. YOUR GIFT IS GREATLY APPRICIATED. THANK YOU!

If you choose, please print this form.
Make check payable to the New York Branch International Dyslexia Assoc. (NYBIDA)

MAIL TO:
International Dyslexia Association—New York, Inc.
71 West 23rd Street, Suite 1527
New York, NY 10010

If you wish to talk with us, please call Jo Haines, (212) 691-1930