Donations

The ChronoRecord Association depends on your donations to continue to contribute to the understanding of mood disorders. Your donation will support ongoing operation of the association.

Donate On-Line

Use the secure form below to make a contribution on-line.

Donor		Individual Anonymous (Do not publish name of contributor) Corporate (Please send any matching gift forms)

Name*
Organization
Billing Address*
City*
State/Province*
Zip/Postal Code*
Country*
Phone*
E-Mail*
Mailing List		Keep me informed


Amount		$500 $100 $50 $25 Other Amount $

Payment Method
Credit Card Number
Cardholder Name
Expiration Date
Security Code

*required data

Donate By Fax

If you do not want to use the donation form online, the completed form can be printed and faxed to

(714) 773-1037

Donate By Mail

If you want contribute by check, print the completed donation form and mail your contribution to

Donations
ChronoRecord Association, Inc.
P.O. Box 3501
Fullerton, CA 92834-3501

Acknowledgement

All donors will receive an acknowledgement of their contribution.

Donor Confidentiality

As a donor, all of your information will be treated as confidential and will not be distributed to other organizations.

Periodically, the ChronoRecord Association may publish recent donor names to thank our contributors. If you do not want your name published in a donor list, please indicate that your donation is Anonymous in the donation form.

ChronoRecord Association

The ChronoRecord Association, Inc. is a non-profit public benefit corporation in the state of California that is qualified under section 501(c)(3) of the Internal Revenue Code. All donations are deductible under federal IRS regulations. Please consult your tax advisor for more information concerning your donation.

The ChronoRecord Association's federal tax identification number (FEIN) is 68-0538096. If you have questions concerning your donation, please contact the ChronoRecord Association at (714) 773-0301 or info@chronorecord.org.