Mail-In Contribution Form

Print this form, fill it out, then send it with a check for the contribution level of your choice to the mailing address below. Thanks for supporting the statewide effort for securing transgender civil rights in Indiana!

All contribution levels include voting rights, periodic updates, subscription to the newsletter, eligibility to serve on committees as well as the option to stand for election to the board of directors. If you have any questions, please contact membership@intraa.org.

Your Name:
Organization
(if applicable):
Email:
Address:
 
Phone:
Annual
Contribution:

Individuals and Couples
$25.00 — Individual
$45.00 — Couple
$100.00 — Sustaining
$120.00 — Bronze Circle
$180.00 — Silver Circle
$240.00 — Gold Circle

Organizations
$75.00 — Sustaining
$150.00 — Bronze Circle
$250.00 — Silver Circle
$500.00 — Gold Circle
INTRAAconnections
$15.00 — Newsletter Subscription Only
Comments:

 

 

 

 

Mailing
Address:

Indiana Transgender Rights Advocacy Alliance
P.O. Box 20386
Indianapolis, IN 46220-0386
Phone: 888.657.1854 (toll free)

INTRAA is a statewide advocacy organization working for freedom of gender identity and expression for all Indiana residents.

*

INTRAA ia §501(c)(4) political advocacy organization. Contributions and membership fees are not tax-deductible.

 

 INTRAA