Saturday, July 31, 2010

Donate

We are requesting support for our education and communication programs. Your support for our work at the NAHU Education Foundation is an important element in our success. Your contribution will help us do the work that we need to do:

Help educate the public
Promote private sector insurance options

Your contribution has never been more needed than it is now. Thank you and we greatly appreciate your consideration of this request.

First Name+
Middle Initial
Last Name+
Membership #
Occupation*+
Employer*+
Employer Address+
Employer City/State/Zip+
Work Phone
Work Fax
Work E-mail+
Home Address+
Home City/State/Zip+
Home Phone
Home Fax
Home E-mail

Required Fields

* A contribution to the NAHU Education Foundation is deductible as a charitable contribution for federal income tax purposes.

Suggested Donor Levels**

Individual Donors will be listed as follows:
$100 Sustaining Donor
$250 Sustaining Friend
$500 Sustaining Patron
$1,000 Benefactor
Other: $

Corporate Donors will be listed as follows:
$250 Bronze
$500 Silver
$1,000 Gold
$2,500 Platinum
$10,000 Diamond
Other: $

**These guidelines for contributions are merely suggestions. You may contribute more or less than the guidelines suggest, and the National Association of Health Underwriters (NAHU) will not favor nor disadvantage you by reason of the amount of your contribution or your decision not to contribute.

Payment Method

I am a new contributor.
This is my regular annual contribution.
This is a new one-time contribution.

MasterCard Visa Discover American Express

Name on Card

Card Number

Expiration Date

By submitting this form, I authorize the NAHU Education Foundation to initiate charges to my credit card as shown above.

Content copyright © 2005-2010 NAHU Education Foundation. All rights reserved.
NAHU Education Foundation · 2000 North 14th Street, Suite 450 · Arlington, VA 22201
703.276.0220 · fax 703.841.7797 · nahuef@nahu.org