Sustainer Form

Yes, I would like to be a monthly contributor to the Consortium for Independent Journalism. Please charge the following amount to my credit card the first of every month until I notify you otherwise:

[  ] $5.    [  ] $10.    [  ] $25.    [  ] $100.    [  ] $______.

Name:_______________________________________

Address:_____________________________________

City/State/ZIP:_________________________________

Visa/MC #:____________________________________

Exp. Date:____________________________________

Contact Info (Phone or E-mail):____________________

Signature:_____________________________________

Please print out this form and mail it to:

Consortium for Independent Journalism (CIJ)
Suite 102-231
2200 Wilson Blvd.
Arlington, VA 22201

(Or if you prefer, you can e-mail the information to consortnew@aol.com, though e-mails are not entirely secure.)

Your donations are tax-deductible.