Donation Form

Southern Sustainable Agriculture Working Group is a 501-c-3 not-for-profit organization chartered in the State of Arkansas and all donations are eligible for tax deduction as allowed by law. 

To pay with check or to have us bill your credit card, please complete this form. Print and mail to the address below.

Name
Farm/Organization
Mailing Address
Phone	E-mail
	I prefer for this gift to remain anonymous. Do not add to public acknowledgement lists.
	Please acknowledge this as a gift or memorial donation in honor of: Name Farm/Org Address Phone Email
Total Donation Amount	$30 $75 $250 $1000 $50 $100 $500 $ (other) Or automatically deduct $ from my credit card every month for the next months.
Payment Preference	My check, made payable to Southern SAWG, is enclosed. Please bill my credit card (provide the following info) Please check card type: MasterCard / Visa Card Number Ex. Date Name exactly as it appears on the card: Billing Address:
Mail this completed form to: Southern SAWG c/o Buckingham Business Services PO Box 22 Hillsborough, NC 27278 Thank you for your generous support.