Education Foundation Donation Form Your donation to the PSIAC Education Foundation 501(c)(3) charitable organization is 100% tax deductible. FacebookThis field is for validation purposes and should be left unchanged.If you would like to submit a donation by check, please disregard this form and mail your check to PSIA-C EF. Address: PSIA/AASI-C, PO Box 2144, Frankfort, MI 49635 Name* First Last Billing Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mailing Address (if different than billing) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* PSIA-AASI National Member ID # (if any)If Tribute Donation please specifify type. In Memory of ... In Honor of ... Please choose the best tribute category.In Tribute Name (if any) If you are making a Tribute Donation please enter the name of the "in tribute" person.Additional Information and/or CommentsPlease share any additional information you'd like to share with us about your contribution.Do you want to remain anonymous?* Yes, I want to remain anonymous No, I don't mind sharing that I am a donor Typically we share Education Foundation donor names (not specific donation amounts) in the Central Line Newsletter. If you'd like to remain anonymous and have us NOT publish you name as a supporter please choose "Yes" above.PSIAC Education Foundation Donation Amount* If you are donating more than $1,000 we would prefer receiving a check to avoid credit card fees - this maximizes your donation to the Education Foundation - thank you!Total $0.00 Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Expiration Date Security Code Cardholder Name