Niku V Donations

TIGHAR accepts personal or corporate checks drawn in US funds; International Money Orders; and VISA or Mastercard. Checks should be made payable to TIGHAR. Please choose the donation you wish to make from the scrolling lists below.

	Use this form to make your NikuV donation on line. Security for your transaction is provided by:
	OR Click Here --> to make your donation via PayPal.

Please fill out the form below completely, and double-check your credit card number. When you press “Submit,” your information will be sent to TIGHAR as a secure transaction.

Name*
Address*
City*	State*	Zip/Postal Code*
Country*
Daytime Phone*	Email*

If you do not have a state, or a Zip or Postal Code, please enter “NONE” in the boxes above to process your order.

NikuV To help us meet the research and analysis funding goal of $150,000 I would like to make a contribution of: .

NikuV One laboratory test costs TIGHAR $250.

I would like to sponsor test(s) for a total of .

NikuV A day of research work by TIGHAR staff costs $500.

I would like to sponsor day(s) of research work by TIGHAR staff for a total of .

TIGHAR accepts VISA and MasterCard for all transactions over US$15.00.

Card Number:*

Expiration Date:*

Amount Charged:*

If you prefer to use mail or fax, please print out the form above send it with a check or credit card info filled in to:

TIGHAR • 2812 Fawkes Drive • Wilmington, DE • 19808 • USA

Or fax to: (302) 994-7945

You can even call us on the telephone and tell us what you want to do: (302) 994-4410

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