AKA Donation Form

Because I care about helping families and individuals touched by adoption, I pledge:


___ Provider ($1 - 99)  


___ Supporter ($100 - 249)      


___ Advocate ($250-499)


___ Sustainer ($500 - 999)


___ Champion ($1,000 & above)



My pledge this year is $___________________________.

(Due by Dec. 31 of this year)


Check of $________ is enclosed.  


I will make installments of $__________________


__ monthly   __ quarterly.     (____Please send reminders.)



My company _____________________________________________________  

has a Matching Gift Program, and I'm enclosing the necessary forms.





Name __________________________________________________________

(As you want it to appear on published donor lists, 


or ___check here if you wish your gift to remain anonymous.)



Mailing Address __________________________________________________



(City/ST/Zip)_____________________________________________________



Employer __________________________________________________________



Your Profession ___________________________________________________



Email Address ________________________________________________________


This gift is in ____ memory  ___ honor of ____________________________



(Please indicate the name and address of the person you wish
to receive acknowledgement about the gift.)


____ I would like volunteer information.


____ I would like AKA to do a program at my school,



church, civic group, etc.


Send this form and payment to:
AKA Inc., PO Box 4082, Austin, TX 78765

AKA, Inc. is a non-profit 501 (c)(3) organization.
Contributions are tax-deductible to the extent allowed by law.

(This form was printed from the Internet)
About AKA | AKA News | Monthly Meetings | Membership & Donation Forms | AKA Volunteer Opportunities
Calendar | Resource Directory | Mailing List | Conferences | Library News | Links | Testimonials | Contact Us