Insurance Industry Charitable Foundation :: IICF :: Helping Communities. Enriching Lives. Together.


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Annual Campaign Contribution

STEP 1: Contribution Amount

Please charge the following amount to my credit card: $

Contribution Levels:
Chairman:	$12,000 or above (minimum investment level for Board of Directors Eligibility)
President:	$5,000 - $11,999
Sr. Vice President:	$2,500 - $4,999
Vice President:	$1,000 - $2,499
Executive:	$999 - $500

Please designate my contribution to:

Specify your designation

Billing Information:

First Name:*
Last Name:*
Address1:*
Address2:
City:*
State:*
Zipcode:*
Telephone:*
Email:*

STEP 2: Sustained Giving Option:

If donating by credit card, you can provide sustained support with a recurring contribution option. Please select one of the following frequencies and your credit card will be charged automatically:
	Quarterly (1st day of every quarter)
	Semi-Annually (every 6 months)
	Annually
	I prefer to give a one-time contribution

Credit Card Information:

Credit Card Type:

Credit Card Number:*

CC Security Code:

Credit Card Expiration Date:

/

STEP 3: Matching Gifts (Check if Applicable):

	My company offers a matching gift program

Step 4: Donor Information:

Name:*
Title:*
Company:*
Address:
City:
State:
Zipcode:
Telephone:
Fax:

STEP 5: Additional Opportunities:

If you wish to receive more information about any of the following, please check the appropriate boxes:
	Volunteer Week (October 14-21)
	Event Sponsorships
	Child Abuse Prevention Program (in Northern or Southern California)
	WorkPlace Campaigns to involve your employees

Resources & Services

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The Foundation is a registered 501 (c) 3 charity: FEIN 20-1240972

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