This is a form to donate money to ACA for supporting the annual April
      Overseas Americans Week (OAW) doorknock campaign in Washington.
 
      Please consider doing more for ACA's work in Washington.  
      Membership dues fund our regular activities,
      however, extra support is needed for financing our delegation to OAW. 
      The annual OAW is one of the most effective ways we have of contacting
      Members of Congress and keeping them informed about our situation as 
      Americans residing outside the USA. 
      Consider making a donation to this worthy cause, in any amount, 
      by filling out the form below.  
      Your donation will be attributed to the "OAW fund."    

      ACA guarantees that your name and address will be held in strictest confidence.
 
      If you want to donate using PayPal®, click here

      To print this form as a pdf file on your computer, click here
      postal address:
      ACA,  5 rue Liotard,  1202 Geneva,  Switzerland

      To donate to ACA, please fill out the boxes below.


        Choose one: 
                   Donation of US$50.00
                   Donation of US$100.00
                   Donation of US$200.00  
                   Donation of US$500.00
                   Other amount: 
                   

      Family Name:  (Required)
       First Name:  (Required)
          Address:  
    Email address:  (Required)
          Remarks: 
ACA guarantees that your name and address will be held in strictest confidence.  
Your email address will be used only for acknowledging your donation. 

Choose your payment method:
 
               By separate bank transfer to 
               UBS SA 
               Case postale
               1211 Geneva 2 
               Switzerland      BIC/Swift: UBSWCHZH12A
                   Bank transfer in US$ IBAN: CH74 0024 0240 2008 0660 P
                   Bank transfer in CHF IBAN: CH30 0024 0240 2008 0600 R  
                  
               Personal check
                   Check (US$ only. Send separately to ACA Geneva) 

               Credit Card (unsecure form; for secure payments use PayPal®)
                   Visa 
                   Master Card
                   American Express

                    Card number:  
                    Expiry date:  Name on card: 


       
          Please enter the answer to the following arithmetic problem:
          What is 24 minus 15 ?   (anti-spam test, required)
          

If you have trouble sending this form via the internet, phone or fax our Geneva office: +41 22 3400233.
or print as PDF and send to: ACA  5 rue Liotard  1202 Geneva  Switzerland or by email .
If you want to pay using PayPal^®, click here