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<!doctype html public "-//w3c//dtd html 4.0 transitional//en">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<meta name="Author" content="CPHV">
<meta name="GENERATOR" content="Microsoft FrontPage 3.0">
<title>On-Line Donations to CPHV</title>
</head>
<body text="#000000" bgcolor="#CCCCCC" link="#0000EE" vlink="#551A8B" alink="#FF0000">
<div align="center"><center>
<table border="0" cellspacing="5" cellpadding="5" cols="1" width="99%" bgcolor="#FFFFFF">
<tr>
<td><img src="imagesnew/emeres.gif" width="342" height="138"> <p><font size="-1" face="Arial,Helvetica">Schools
across the nation have started again, and like all other Americans, we live in terror of
another Columbine, or another Los Angeles. We are grateful that you've offered your help
in</font> <br>
<font size="-1" face="Arial,Helvetica">this mission to end such senseless violence. Now is
the time to act - America's children deserve safe schools and communities, free from the
fear of gun violence.&nbsp;</font> </p>
<p><font size="-1" face="Arial,Helvetica">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>If
you would prefer to contribute by phone, please call</font></b> <br>
<font size="-1" face="Arial,Helvetica"><b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
The Center to Prevent Handgun Violence at (202) 289-7319&nbsp;</b></font> </p>
<p align="center"><font size="-1" face="Arial,Helvetica">Or, you may print out this form
and send it to us at the address below. We will have and on-line form shortly.&nbsp;</font>
<br>
&nbsp; </p>
<div align="center"><center><table border="0" cellspacing="3" cellpadding="3" cols="3" width="100%">
<tr>
<td><font size="-2" face="Arial,Helvetica">Prefix:____________________</font></td>
<td><font size="-2" face="Arial,Helvetica">First Name:_________________________</font></td>
<td><font size="-2" face="Arial,Helvetica">Middle Initial(s):______________</font></td>
</tr>
<tr>
<td><font size="-2" face="Arial,Helvetica">Last Name:&nbsp;_______________</font></td>
<td><font size="-2" face="Arial,Helvetica">Address:&nbsp;__________________________</font></td>
<td><font size="-2" face="Arial,Helvetica">Address:___________________</font></td>
</tr>
<tr>
<td><font size="-2" face="Arial,Helvetica">City:&nbsp;_____________________</font></td>
<td><font size="-2" face="Arial,Helvetica">State:&nbsp;_____________</font></td>
<td><font size="-2" face="Arial,Helvetica">Zip:&nbsp;_______________________</font></td>
</tr>
<tr>
<td><font size="-2" face="Arial,Helvetica">E-mail:&nbsp;____________________</font></td>
<td><font size="-2" face="Arial,Helvetica">Phone:&nbsp;_____________________</font></td>
<td></td>
</tr>
</table>
</center></div><p><font size="-1" face="Arial,Helvetica">&nbsp;</font> <br>
<font size="-1" face="Arial,Helvetica">To learn more about about how to include the Center
in my estate plan</font> </p>
<p><img src="bear1.jpg" width="186" height="82"> </p>
<p><font size="-1" face="Arial,Helvetica">Contribution:&nbsp;</font> </p>
<p align="center"><font size="-1" face="Arial,Helvetica">I want to do my part to make
certain that children are returning to school this</font> <br>
<font size="-1" face="Arial,Helvetica">year without the fear of gun violence. That's why
I'm making a contribution to&nbsp;</font> <br>
<font size="-1" face="Arial,Helvetica">help the Center to Prevent Handgun Violence expend
its life-saving programs</font> <br>
<font size="-1" face="Arial,Helvetica">into my community and across the nation and&nbsp;
end the terrible tragedy of children</font> <br>
<font size="-1" face="Arial,Helvetica">killing children in the amount of:&nbsp;</font> <br>
&nbsp; </p>
<div align="center"><center><table border="0" cellspacing="6" cellpadding="3" cols="3" width="100%">
<tr>
<td><font size="-1" face="Arial,Helvetica">$250</font></td>
<td><font size="-1" face="Arial,Helvetica">&nbsp;$100</font></td>
<td><font size="-1" face="Arial,Helvetica">$75</font></td>
</tr>
<tr>
<td><font size="-1" face="Arial,Helvetica">$35</font></td>
<td><font size="-1" face="Arial,Helvetica">&nbsp;$20</font></td>
<td><font size="-1" face="Arial,Helvetica">$15</font></td>
</tr>
<tr>
<td><font size="-1" face="Arial,Helvetica">Other Amount:&nbsp;</font> <br>
&nbsp; <br>
&nbsp;</td>
<td></td>
<td></td>
</tr>
</table>
</center></div><p> <font size="-1" face="Arial,Helvetica">Payment Options&nbsp;</font> </p>
<p align="center"><font size="-1" face="Arial,Helvetica">Please charge my credit card the
amount I have indicated above.&nbsp;</font> &nbsp; </p>
<div align="center"><center><table border="0" cellspacing="3" cellpadding="6" cols="3" width="100%">
<tr>
<td><font size="-1" face="Arial,Helvetica">Charge my:&nbsp;</font></td>
<td><img src="imagesnew/visa1.gif" width="60" height="38"></td>
<td><img src="imagesnew/mc.gif" width="113" height="68"></td>
</tr>
<tr>
<td><font size="-1" face="Arial,Helvetica">Number:&nbsp;___________________</font></td>
<td><font size="-1" face="Arial,Helvetica">Name on Card:&nbsp;___________________________</font></td>
<td><font size="-1" face="Arial,Helvetica">Expiration Date</font> <br>
<font size="-1" face="Arial,Helvetica">(MMYY):&nbsp;_______________________</font></td>
</tr>
</table>
</center></div><p align="center"><font size="-1" face="Arial,Helvetica">Please Print out
this form and mail to:</font> </p>
<p align="center"><font size="-1" face="Arial,Helvetica"><b>Center to Prevent Handgun
Violence, 1225 Eye Street, NW, Suite 1100</b></font> <br>
<font size="-1" face="Arial,Helvetica"><b>Washington, D.C.</b></font> <br>
<font size="-1" face="Arial,Helvetica"><b>20005</b></font> </p>
<p><font size="-1" face="Arial,Helvetica"><i>Contributions to the Center to Prevent
Handgun Violence are tax deductible.&nbsp; Please consult your tax advisor.&nbsp; If your
company has a charitable giving program, please ask the personnel office about matching
your gift.</i></font></td>
</tr>
</table>
</center></div>
</body>
</html>