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Please print and complete this form, and mail it along with your check to:

Ipas Development
P.O. Box 5027
Chapel Hill, NC USA 27514


Amount of Gift

Name

Address

City

State

Zip

Country

e-mail

phone

________________________________

________________________________

________________________________

________________________________

________________________________

________________________________

________________________________

________________________________

________________________________

________________________________

 

____I prefer to remain anonymous.


____My company has a matching gift
program. The required form is enclosed.


____I would like to receive periodic
updates about Ipas’s programs around the world, sent by regular mail or e-mail.


____I would like to discuss a planned gift. Please contact me at the address/
phone listed to the right.

Ipas is a registered 501(c)(3) nonprofit organization. All contributions to Ipas are tax deductible to the full extent allowed by law.