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Thank you for your generous support of Green Empowerment (Tax ID #93-12330409).
Print out this form (use icon at top right) and mail it to:
Green Empowerment
140 SW Yamhill
Portland, OR 97204
I support your work for local leadership, sustainability and social justice.
Name________________________________________________________________
Address______________________________________________________________
City____________________________State_________________Zip______________
Phone__________________________Email_________________________________
Enclosed is my contribution of:
__$250 __$100 __$75 __$45 __$35 __Other
Please charge my ___Visa ___Mastercard
Card #________________________________
Expiration Date__________________________
Signature_______________________________
Giving in Honor or Memory
This contribution is made in __honor or in __memory of _________________________.
Please choose whether you would like this gift to support:
__Light for Villages
__Water for Villages
__Rainforest Conservation
__Area of Greatest Need
Please send a gift card to:
Name________________________________________________________________
Address______________________________________________________________
City____________________________State_________________Zip______________
Phone__________________________Email_________________________________
Circle of Renewal Monthy Giving Program
 As a member of the Circle of Renewal Monthly Giving Program, your monthly donation, automatically transferred each month from your checking account or charged to your credit card, provides steady reliable support-allowing us to initiate projects more quickly, plan more effectively, and reduce administrative costs.
I authorize Green Empowerment to charge $_____________each month to may credit card listed above or transfer $_____________each month from my bank account. If authorizing an EFT transfer from your bank, please include a completed check for this month’s payment.
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