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Donate Volunteer 30th Annual Benefit Celebration

Mail/Fax Form

Please fill out the form below, and fax it to 212-564-3524 or

Send your check and this form via mail to:

Chess-in-the-Schools
Development Department
520 Eighth Avenue, 2nd Floor
New York, NY 10018


Donor Name: 

Street Address: 

City: 

State: 

ZIP: 

Phone: 

Email: 

Donor wishes to remain anonymous

My tax-deductible contribution is enclosed:
Check
or Please bill my credit card:                       
Visa
MasterCard
American Express

Donation Amount:  $

Contribution Designation, if any:  

Credit Card number: 
(eg: 1234-5678-9012-0000)

Expiration Date: 
(
eg: 09/98)

Credit Card Security Code: 
(three or four digit code
located on the back of the card)

SIGNATURE: ______________________________________________

Name on Credit Card: 

  My employer has a Matching Gift program. Enclosed with my check is my company's form or I will forward the form in the mail.

This gift is in :   
in honor of
in memory of

Please notify Honoree's Name: 

Honored Event or Occasion:  
(optional)
Address: 

City:    

State:   

ZIP:  


Thank you for your help! Your gift will be acknowledged through the mail.

Chess-in-the-Schools is a 501(c) 3 not-for-profit organization.  Our tax ID number is 13-6119036.  A copy of our most recent financial information may be obtained directly from Chess-in-the-Schools or from the Office of the Attorney General, NY State Department of Law, Charities Bureau, 120 Broadway, New York, NY 10271

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Chess in the Schools | 520 Eighth Avenue, Floor 2 New York, NY 10018
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