Context Institute Donation-by-Mail Form

Print out this form, fill it in, then mail it (with your check) to us at the address below.

1. Donation Amount in U.S. Currency $______________ Thank You!

2. Please make check payable to Context Institute, fill out section 3 below, and mail it to the address at the bottom of this form.

3. Information about you so we can send you a thank you and receipt

Name ______________________________________________________

Street Address ________________________________________________

City _______________________________________________________

State _______________________________________________________

Zip or Postal Code ___________________________________________

Country ___________________________________________________

Day phone:________________________________________________

Evening phone:_____________________________________________

email address_______________________________________________

Context Institute * PO Box 946 * Langley, WA 98260 * USA
Tel: 360/221-6044