Education Foundation Donation Form

Your donation to the PSIAC Education Foundation 501(c)(3) charitable organization is 100% tax deductible.

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 State ZIP Code
Mailing Address (if different than billing)
Street Address City 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 Comments
Please 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 Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Phone
This field is for validation purposes and should be left unchanged.