DRC Contribution Form

DRC Project Donation Form

Please indicate the project you would like to support by placing the amount of your donation next to the project name:

DRC Relief Fund

DRC Scholarship Fund

Dom Community Center in Jerusalem

Tahaddi Projects

Total

Donation Preferences:

Please provide my name and contact information to the project organizers.
Please provide my name to the project organizers, but keep my email address private.
Please do not provide the project organizers with any information about me.
I prefer to make this donation anonymously.

Please send me periodic updates on the progress of the project(s) I support.

Please complete this form, print and mail it along with your donation to:

Dom Research Center, Inc
PO Box 121
McComb, MS 39649
U.S.A.

A receipt will be sent to you to acknowledge your donation.

Last Name:
First Name:
Initial:
Address 1:
Address 2:
City:
Country:
Zip/Postal Code:
Email Address:
Home Phone Number:

To make your donation on behalf of or in memory of another person, please enter the person's name below. (optional)