World Institute on Disability Donate to WID by Mail Gifts can be made by check, payable to the World Institute on Disability. Or, charge your gift: Name:_______________________________________________ Address:_____________________________________________ City:________________ State:________ Zip:_______________ E-mail: ______________________________________________ Phone: ______________________________________________ VISA____ MASTERCARD_____ AMERICAN EXPRESS______ Card Number:________________________ Expiration Date:________ Signature:______________________________________ Print this form and mail to: Institute on Disability Attn: The Development Department 3075 Adeline Street, Suite 155 Berkeley, CA 94703
World Institute on Disability Donate to WID by Mail Gifts can be made by check, payable to the World Institute on Disability. Or, charge your gift: Name:_______________________________________________ Address:_____________________________________________ City:________________ State:________ Zip:_______________ E-mail: ______________________________________________ Phone: ______________________________________________ VISA____ MASTERCARD_____ AMERICAN EXPRESS______ Card Number:________________________ Expiration Date:________ Signature:______________________________________ Print this form and mail to: Institute on Disability Attn: The Development Department 3075 Adeline Street, Suite 155 Berkeley, CA 94703