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To send a check, money order or make a credit card contribution BY MAIL please print this form, fill it out, and mail it along with your donation to:
 The Senior Citizens League
 909 N. Washington St. #300
 Alexandria, VA 22314  WDM1A1

Title: ____ First Name: _______________ MI: ___ Last Name: ____________________

Mailing Address Line 1: ___________________________________________________

Mailing Address Line 2 (if needed): ___________________________________________

City: ____________________________________ State/Province ________

Zip/Postal Code ________________ Country ________________________

Email Address: ________________________________________________

I'm making the following contribution to join with you and other TSCL members and supporters to help your nationwide grassroots campaigns for a Fair and Accurate Cost-of-Living Adjustment, Notch Reform, Prescription Drug coverage and other issues of importance to senior citizens:

$10   $15   $25   $40   $__________ (other)

Contributions or gifts to The Senior Citizens League are not deductible.  Contributions are voluntary, and  no government funds are accepted.

The League's newsletter, The Social Security & Medicare Advisor, is available via e-mail.  This newsletter is packed with useful information and supporters tell us they regularly obtain helpful and money-saving information from it. Recipients of the newsletter via e-mail will also receive Legislative Alerts via e-mail in the event there is important legislative activity on Social Security & Medicare related legislation.

[  ] Please send me The League's newsletter, The Social Security & Medicare Advisor, by e-mail.  Please print your e-mail address below:

___________________________________________________

__ I am enclosing a check payable to "TSCL".
__ I am providing the information below to make my donation using my credit card.
Credit Card Type: Visa Mastercard American Express Discover Card
Credit Card Number: _____________________________________ Exp Date: _________
Signature: _________________________________________________