Please fill out this form and mail it to:
VDare Foundation
PO Box 211
Litchfield, CT 06759
Name: _________________________________________________________________
Address:_________________________________________________________________
_________________________________________________________________
City: _________________________________________________________________
State: __________________________________________________________________
Zip: __________________________________________________________________
Email: __________________________________________________________________
Phone: __________________________________________________________________
Amount: ______ $50
______ $100
______ $500
______ $1,000
______ Other: __________