Francis D. Murnaghan, Jr. Appellate Advocacy Fellowship, Inc.
Print and complete this form. Mail with contribution to: Murnaghan Appellate Advocacy Fellowship c/o Public Justice Center, Inc. 1 N. Charles Street, Suite 200, Baltimore, MD 21201
Donor Information Form
Donor Name: ___________________________________________ Name as it should appear in publicity acknowledging donors: same as above List as: _______________________________________________ We wish to remain anonymous Donor Address: _____________________________________________ City __________________ State _______________ Zip_____________ Telephone Number (required for all credit card charges) (_____)____________ Email _____________________________________________________ Total donation amount $__________________ Check Enclosed (Payable to ”Murnaghan Appellate Advocacy Fellowship”) Charge my credit card (Note: credit card will be processed through the Public Justice Center, Inc.) One payment Monthly installments $_________ for ____ months Credit Card information: Mastercard Visa American Express Discover Number: _________________________Exp. Date: _______/________ Signature: _________________________________________________ Please Note If your contribution is in memory or honor of someone, please tell us who: ________________________________________________________________ Indicate the person(s) we should notify of your gift: Name: _________________________________ ________________________________ Address: _______________________________________________________________ _______________________________________________________________________
Disclosure Statement: The Frances D. Murnaghan, Jr. Appellate Advocacy Center is a Maryland nonprofit corporation that is recognized as a charitable, tax-exempt organization under Internal Revenue Code section 501(c)(3). A copy of the Murnaghan Fellowship’s financial statement is available upon request by contacting the Public Justice Center, Inc., 1 N. Charles St., Suite 200, Baltimore, MD 21201. Documents and information submitted under the State of Maryland Charitable Solicitations Act are available from the Office of the Secretary of State of Maryland, Annapolis, MD 21401 for the cost of copying and postage. Credit card payments are processed through the Public Justice Center, Inc., a Maryland 501(c)(3) charitable organization.