Payment and Donation Form

Donate or Make Payment

Name (required)

Address (required)

Address2

City (required)

State (required)

Zip (required)

Country (required)

Phone (required)

Day/Evening:  Day Evening

Your Email (required)

Please specify below what the payment is for:

Payment for: (required)

Amount of Payment: $ (required)

Also, I am enclosing a donation to be used for:

Purchase Library Material $

General Fund $

Credit Card
---MastercardVisaAmerican ExpressDiscover

Name on Card

Card Number

Expiration Date

Month
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Year
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IMPORTANT: This form will be processed online separate from the shopping cart and will charge it to your credit card. This allows the processing of your donation separate from any order you may place. The donation WILL NOT appear in your online AFGS shopping cart.

If you prefer not to make a donation online, you may fill out the form but instead of submitting it, print the form and mail it to: