| ___ Yes, I support the Foresight effort! Keep me informed about Foresight's work over the next year. Here is my donation or new membership which will be doubled through the challenge grant. Foresight is a nonprofit organization; donations are tax-deductible in the U.S. to the full extent permitted by law. |
This Challenge Grant donation is for:
One-time Donation:
___ $100
___ $500
___ $1000
___ other (please enter amount: $_________)
New Basic Foresight Membership:
___ $60
New Foresight Senior Associate Membership:
___ Associate: $250 annually for five years
___ Fellow: $500 annually for five years
___ Colleague: $1000 annually for five years.
___ Friend: $5000 annually for five years.
Renewal of Senior Associate status after fulfilling a 5-year pledge:
___ Associate: $250 annually for five years
___ Fellow: $500 annually for five years
___ Colleague: $1000 annually for five years.
___ Friend: $5000 annually for five years.
Upgrading to a higher membership level for the remainder of my five-year Senior Associate term. I am upgrading to the level indicated below (either Fellow, Colleague, or Friend).
___ Fellow: $500 annually for five years
___ Colleague: $1000 annually for five years.
___ Friend: $5000 annually for five years.
Please confirm the amount to charge your credit card: $_________
___ A matching gift will be made by my company |
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Contact Information
Title: ______ First Name(s): ___________________
Last Name: _________________________
Address: ___________________________________
Address: ___________________________________
City, State: ___________________________________
Zip/Postal Code, Country: _________________________
Phone: __________________ Fax: __________________
Email: ___________________________________
Payment Information
Name on credit card:_______________________________
VISA or Mastercard Number:________________________________
Exp. Date:_________ (Month/Year)
Signature________________________________ |
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My donation is enclosed, payable to the Foresight Institute. Foresight is a nonprofit organization; donations are tax-deductible in the U.S. to the full extent permitted by law. Donations can be made by check from a U.S. bank, postal money order, VISA, or Mastercard (AMEX not accepted). Credit card donations may be sent by fax. You will receive a receipt for your tax-deductible donation.
To discuss major gifts or ask questions, contact Foresight at 650-917-1122. |