HELP BUILD THE CULTURE OF LIFE! TO DONATE BY MAIL, COMPLETE THIS FORM AND SEND TO: Arch of Triumph of the Immaculate Heart of Mary, P.O. Box 2817, Buffalo NY 14240. FAX YOUR CREDIT CARD DONATION TO (716) 856-1494. Please call Toll Free (866) 205-6512 to donate by phone, or if you have any questions.
Name(s)____________________________________________________________

Street_________________________________City/Town____________________

State/Province_______Zip/Postal Code_____________Country______________  

Telephone:  (___)______________  E-mail__________________________

Donation: In U.S. funds: $100 __ $ 175 __ $ 250 __ $500 __ $1000 __ $2000 __ 

Other $ _____ Make checks payable to Arch of Triumph of the IHM.  Please 

consider adding $7.00 to defray transaction costs.  All contributions are tax-deductible—
Canadians, please make checks payable to our Canada partner, Our Lady Queen of 
Peace Centre, for tax purposes.
CHARGE circle one: Visa / MasterCard / American Express / Discover
Card Number_____________________________________ Expiration ___ /___
Signature:  ________________________________________

PLEDGES:  I wish to pledge a total donation of $_________(U.S.), and am 
sending now my first check in the amount of $_________ OR, and I authorize monthly 
charges to my account of $_________ for _______ (how many?) months. 
Inscription(s) requested:_______________________________________________
____________________________________________________  I am donating 
$2000 or more, and would like also an engraved plaque placed in the Chapel of the
(circle one) Sacred Heart / Immaculate Heart / Triumph / Holy Innocents to be 
inscribed: ____________________________________________________________
_____________________________________________________________________
_________________________________(maximum 100 characters, including names).

We will enter your inscription information on the VIRTUAL Arch immediately.
(Note: all qualifying donors may request virtual inscriptions in addition to names of persons, couples, families or groups! Just enter it on the lines above.)

DONATION LEVELS: ALL donations are gratefully received! Incentives: $100 – One name of a person, living or deceased, born or unborn, inscribed on Arch of Triumph of IHM, and also upon the VIRTUAL ARCH. $175 – Name of a wedded couple or family. $250 – A group name. $1000 – Receive also a signed certificate of appreciation. $2000 – Also may have an engraved bronze plaque placed in chapel of your choosing. To arrange larger dedicatory gifts, contact Executive Director Laurence D. Behr, Esq., (716) 856-1300. VISIT US ON THE WEB AT: www.ArchofTriumph.org.

Pray the Rosary daily for WORLD PEACE.  Thank you for your prayers and support!