One Time Donation

Contribution Form

To make a donation to Renovaré, print, fill out, and mail this form to:
Renovaré
8 Inverness Drive East - Suite 102
Englewood, CO 80112-5624 USA

or fax to: 303-792-0146

Please do not e-mail the form as we cannot guarantee the security of the credit card information. Thank you!

Renovaré is a non-profit corporation organized under the Internal Revenue Service 501(c)3 code. Your donation is tax-deductible to the extent allowed by law. Contributions of $10US or more will be receipted via surface mail, so please include your full mailing address.


Donation Amount: ____________________	Date: ______/_____/_____

• If contributing by check, please make payable to Renovaré (U.S. Funds on a US Bank, please).

• If contributing by credit card, please fill out the following:

___ AMEX

___ Discover

___ MasterCard

___ Visa

Card Number:	______________________________________________________

Expiration Date: ___/___/___	Security Code: ________

Name on Card:	______________________________________________________

Signature:	______________________________________________________

Printed Name:	______________________________________________________

Organization:	______________________________________________________
	(if necessary for mailing address)
Address:	______________________________________________________

	______________________________________________________
City, State:	___________________	Country / Postal Code: _____________________

Phone:	___________________	Email: __________________________
	(in case we have questions)