My Name _______________________________________________
Yes, please consider me a _________ A FRIEND OF ADOREMUS!
Address ________________________________________________
City _______________________________
State/Province _____________ Zip/Postal Code _________________ Check here if new member or address change.
My gift is enclosed: ____$50 (Friend) ____$100 (Patron) ____$200(Sustaining)
____$500 (Jubilee) ____$1000 (Millennium) ____$5000 (Benefactor)
____$10000 (Duc in Altum)
NOTE: All contributions are tax-deductible (United States) .
SPECIAL OFFER to ADOREMUS FRIENDS!
Send a gift of ADOREMUS BULLETIN to your friend(s) at a special discounted rate!
_____ Please send a oneyear gift of Adoremus Bulletin in my name (see form below). I am including a contribution at the special discounted rate of $20* ($30 outside US) for each gift. (Regular $30, or $40 non-US)
*Donors of $100 or more to this"Friends of Adoremus Appeal", may request 2 FREE gift subscriptionsTotal amount enclosed: $ ___________ Please make check payable to Adoremus Send to: ADOREMUS PO Box 300561, St. Louis, MO 63130 (Envelope enclosed for your convenience)
_____ Please do NOT list my name on your published list of donors.
_____ I wish to make monthly donations to Adoremus. Please send me envelopes for this purpose.
Please send Adoremus Bulletin for one year as my gift to:
Name ___________________________________________________
Address _________________________________________________
City _______________________________
State/Province _____________ Zip/Postal Code ___________
Country ________ (Use back of sheet for additional names)