Georgia Network to End Sexual Assault

Since GNESA is a non-profit organization we rely solely on grants and the generous support of concerned individuals like you. There are many ways you can contribute to eradicating sexual violence and one of them involves donating to GNESA. The benefits of membership include access to:

Legislative information
News on public policy achievements and research
GNESA's newsletter
Reduced attendance fees to GNESA's special events, conferences and workshops
Access to GNESA's library and statistics on sexual assault

To make a donation and/or become a member of GNESA, complete and submit the form below. Fields with a * are required.

Name*

Address*

City*

County*

State*

Zip*

E-Mail*

Phone

Fax

Membership level

	$50 Friend
	$75 Sexual Assault Nurse Examiner (SANE)
	$25 Student/Limited Income
	$50 Supporting Organization
	$100 SART

Donation (in addition to or in lieu of membership)

Amount of donation
Is this donation in memory of or honor of someone? If so, please complete the following section.
	This donation is in memory of:

	This donation is in honor of:

*Total amount of donation:** (required)

Payment method

	I will mail my check/money order (payable to Georgia Network to End Sexual Assault)
	Credit Card Payment, via donate.net (instructions will appear on the screen after you submit this RSVP form)
My donation will be paid in full by: