please print and fill out this donation form; make your check payable to It Happened to Alexa Foundation and mail it to:

It Happened to Alexa Foundation
125 South First street,
Lewiston, New York 14092
Phone: (716) 754-9105
Fax: (716) 754-4676

Donation Amount

I would like to make a donation of:

________$1,000
________$500
________$250
________$100
________$50
________$25
$Other ______________

Contact Information

Name_____________________________________

Street Address _____________________________

Suite/Apt number ___________________________

City_______________________________________

State______________________________________

Zip/postal code______________ Country___________

Email______________ Daytime phone number_(____)____________

Many employers now match their employees' charitable contributions

Ask your Human Resources or office benefits department if your
company offers this benefit.

A matching gift will do twice as much to help victims of sexual assault
if your contribution will be matched. It costs you nothing additional for the match.

Just mail your company's matching gift form along with your contribution. We'll take it from there.

Thank you for your generous gift.

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