Payment Form

Page 1

ALFA suggests all sponsors and philanthropic supporters donate directly to the charities we serve through financial contributions.

AIRLIFT FLYERS AVIATION CORP. Please Print or Type

DONATION BY CHECK, MONEY ORDER OR CREDIT CARD PAYMENT FORM PH: 305-470-1500 FX: 305-470-1502 Email: fly@alfa.aero

Please mail checks to: Airlift Flyers Aviation Corp. 12105 SW 109 Court Miami FL 33176

Organization or Company Name: ___________________________________________________________ D/B/A or Affiliation (if any): ______________________________________________________________ Address / City / State / Zip : _______________________________________________________________ Main Telephone # _______________________________

Fax # _____________________________

Representative: _____________________________________

Title: _____________________________

Signature: _________________________________________

Date: _____________________________

I HAVE READ THIS AGREEMENT AND I AGREE TO ITS TERMS _______

(Initial here)

PLEASE PROVIDE THE FOLLOWING TAX STATUS INFORMATION IF DONOR REQUIRES Federal ID#__________________________ State.# _________________________ Tax Exempt # ___________________________

I/We am/are a Corporate Sponsor I/We am/are an Individual Partner I/We am/are a Private Benefactor I/We am/are a Non-Profit Organization or NGO:

________________ ________________ ________________ ________________ Form of payment:

$________________ $________________ $________________ $________________ ____________________ (Check, money order, etc.)

Credit Card_______________________________ Credit Card # ________________________________ Card Holder_______________________________ Expiration Date _______________________________ (Print Name)

PAYMENT TERMS:

Payment of more than US$50.00 must accompany this gift. Make checks payable to Airlift Flyers Aviation Corp. 90% refund up to 30 days. No refunds will be made after 30 days.

PRIMARY SERVICE REQUEST (please see Donor’s Focus of Interest in this section of the website) _____________________________________________________________________________________ _____________________________________________________________________________________

Please indicate a Focus of Interest Area to nominate a recipient non-profit organization or NGO which exemplifies or represents or is consistent with the Donor’s intentions and utilize the gift according to the Donor’s purpose.

PLEASE COMPLETE AND TRANSMIT THIS FORM BY E-MAIL rick@alfa.aero OR BY FAX No. 305-470-1502


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