Contact NOW-New York State for more information on leaving a bequest.

To donate by check or money order (payable to NOW-NYS), print this form and mail with your donation to: NOW-New York State, 1500 Central Ave., Albany, NY 12205.

Name:
Address:
City/State/Zip:
Work Phone:
Home Phone:
E-mail:
Comment:
Amount:	$
Credit Card Type:	MasterCard Visa
Credit Card Number:	four digits per box
Exp Date:	mo 01 02 03 04 05 06 07 08 09 10 11 12   year 2005 2006 2007 2008 2009 2010 2011 2012
Name as it appears on card: