Planned Parenthood Association of Bucks County

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Planned Parenthood Association of Bucks County Donation Form

Please print this form and mail it with your donation to:

Planned Parenthood Association of Bucks County
610 Louis Drive
Warminster, PA 18974

Yes, I want to help Planned Parenthood Association of Bucks County protect reproductive freedom, offer quality and affordable healthcare, and provide sexuality education to the youth in our communities.

*Giving Levels*
Leaders’ Circle	$10,000+
Sustainer	$5,000 - $9,999
Pillar	$2,500 - $4,999
Benefactor	$1,000 - $2,499
Patron	$500 - $999
Sponsor	$250 - $499
Donor	$100 - $249
Friends	$1 - $99

I wish to make a gift to Planned Parenthood Association of Bucks County. The purpose of my gift is for ________________________________________

Enclosed is my gift of $__________________

Check made payable to Planned Parenthood Association of Bucks County

Visa Credit Card #: _______________________________ Exp. Date: __________

Mastercard Credit Card #: _________________________ Exp. Date: __________

Please notify the following that this gift has been made:

Name: ______________________________________________________
Company: ___________________________________________________
Address: ____________________________________________________
City, State, Zip: _______________________________________________
Home Phone: __________________ Work Phone: __________________

Please check here if you wish to remain anonymous.

THANK YOU FOR YOUR SUPPORT.

The official registration and financial information of Planned Parenthood may be obtained from the Pennsylvania Department of Sate by calling toll free, within PA, (800) 732-0999. Registration does not imply endorsement.

610 Louis Drive
Warminster, PA 18974
(215) 957-7981
FAX: (215) 957-9668

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