Yes! I want to support the LIFE MEMBERS FUND
(to invest in the next generation of child and adolescent psychiatrists)
Name: ______
I CHOOSE TO DONATE: (1)
□ $400 □ $1,000 □ $2,500 □ Other $ ______
□ Please send me more information about making a bequest gift to AACAP
□ I have enclosed a check made payable to:
American Academy of Child & Adolescent Psychiatry
Please charge my: □ American Express □ MasterCard □ Visa
Name as it appears on the card: ______
Credit Card number: ______
Expiration Date (month/year): ______Security Code: ______
Signature: ______Date: ______
You can return this form in one of three ways:
Mail: Fax: Email:
AACAP 202-966-5894
P.O. Box 96106
Washington, DC 20090-6106
(1) The full amount of this gift qualifies as a charitable deduction