THE TIBET FUND ~ BLUE BOOK MEMBERSHIP
 Yes, I would like to become a Blue Book Member at the level indicated:
$1,000 per year
$500 per year
$250 per year
$100 per year
$_______ Other
 Method of Payment:
Check or Money Order Enclosed (please make payable to The Tibet Fund)
Credit Card (your signature below authorizes The Tibet Fund to charge your credit card as indicated):
Amount of $_________for a period of: ________ months beginning ________as follows:
Annually Semi-annually Quarterly Monthly One-time donation only
Visa MasterCard American Express

Credit Card Number:__________________________________________________ Expiration Date:____________

Card Holder's Signature:_____________________________________________________
 Donor Information:


Name:  _______________________________________________________

Address:  _____________________________________________________

City:  ________________________________________________________

State:   ___________________   Phone:  ____________________________

Zip: _______________________Email: ____________________________________

Please mail this form and your payment to:

The Tibet Fund
241 East 32nd Street ~ New York, NY 10016
phone: (212) 213-5011 ~ fax: (212) 213-1219
email: tibetfund@tibetfund.org ~ web: www.tibetfund.org

The Tibet Fund, founded in 1981, is the principal fund-raising organization for the Tibetan people, established to help preserve and promote their unique cultural heritage. The Tibet Fund assists the educational, social, and economical advancement of Tibetans, both in and outside of Tibet. The Tibet Fund is a non-profit 501(c)(3) charitable organization; accordingly, contributions are tax-deductible to the extent allowed by law.

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