Please send in your donation with this form to

:

Newsday Charities Processing Center
25257 Network Place
Chicago, IL 60673-1252

Personal Information:
Prefix ________

First _______________________ M.I. ________

Is this donation on behalf of an organization?

Ƒ

Yes

Ƒ

Last ______________________________ Suffix ______

No

Org. Name ___________________________________________________________________________________________________
Street Address ___________________________________________________________________________
City ________________________________________________________ State _______
Phone (

) _______________________

Apt./Unit ___________

Zip ______________

Email _______________________________________________________________

Donation Information:
I would like to make a gift in the amount of:

$___________

____ Enclosed is my check payable to Newsday Charities
____ Please charge my:

Ƒ

Visa

Ƒ

MasterCard

Ƒ

Discover

Card Number __________________________________________ Exp. ______
(The McCormick Foundation will appear on your statement)

Ƒ

American Express

Signature ________________________________

____ I would like to give monthly. Please charge my credit card $______ on the first Monday of every month until further notice.
____ Enclosed is my employer matching gift form.
Your name and donation information may be published in future McCormick Foundation reports. Please indicate your preference.

Ƒ
Ƒ

Yes, the McCormick Foundation has my permission to publish my information.
No, do not publish my information.

Newsday Charities is a fund of the Robert R. McCormick Foundation, a registered 501(c)(3) organization, IRS registration #36-3689171. Your gift is tax
deductible to the extent allowed by law. An acknowledgment will be sent for your records. A copy of the latest annual report may be obtained from the
Foundation by calling 312-445-5044 or from the Charities Bureau, Department of Law, 120 Broadway, New York, NY 10271. The McCormick Foundation and
Newsday respect your right to privacy and do not trade or sell donor names.

NCRCDF

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