Media Research Center Printable Donation Form

YES! I agree the liberal media has a stranglehold on the American public. I want to help the Media Research Center expose the media's liberal agenda and educate more Americans about the need for balanced reporting.

Enclosed is my tax-deductible gift in the amount of:

___ $10 - Booster: One time donation

___ $25 - Member: Receive MRC's monthly newsletter Flash

___ $50 - Supporter: Receive invitations to all MRC (not all are complimentary)

___ $100 - Advocate: Receive 5% discounts on all MRC merchandise

___ $250 - Watcher: Receive 10% discounts on all MRC merchandise

___ $500 - Anchor: Receive issues of Notable Quotables

___ $1,000 - Associates: Receive participation in Board of Trustees Meeting and Luncheon and two tickets to the annual MRC Gala in Washington, D.C.

$_____________ Other Amount

___ Please send details on how to contribute stock to MRC.

___ Please send details on how to make MRC part of my will.

Name: _______________________________________________________

Address: _____________________________________________________

City: __________________________ State: _________ Zip: __________

Country (if not U.S.A.): __________________________________________

Telephone: ____________________ (in case there is a question about your credit card)

Email: _____________________

___ Visa

___ American Express

___ MasterCard

___ Discover

Card Number: _________________________________________________

Expiration Date: ____________________

Name as it appears on card: ______________________________________

Thank you for your support!

Please mail this form and your gift to:
Media Research Center
Attn: MRC Development
325 S. Patrick Street
Alexandria, VA 22314
(800) 672-1423 | Fax: 703-683-9736

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