Contribution Form

Fill out this form and print it from your browser Mail it to the address below.

Yes, I am impressed with the accomplishments of the AAPI Charitable Foundation and support its goals. Enclosed is my donation.

Name:________________________________________________________ Address:___________________________________________________________________________________________________ __________________________________________________________________________________________________________ Phone:________________________________________________________ $1,000 $500 $100 $ Other ______

All donations to the AAPI Charitable Foundation are tax deductible. Tax I.D. # 86-0586053

Medical Equipment and Supplies Physician Fellowship Training Fund Basic Medical Care Scholarship Fund Pramukh Swami Eye Hospital, Bombay

Please make your check payable to the: AAPI Charitable Foundation Mail to: AAPI Charitable Foundation 600 Enterprise Drive, Suite 108 Oakbrook, IL 60523 For Information: call (630) 990-2277