CIMA Inc.
Core Institute for Motivational Advancement
(“Inspiring Excellence”)
Donations

How much would you like to give?

___ $500.00 __ $250.00 ___$125.00 ___ $55.00

If you would like to make a donation at the leadership level, please choose one of the following:

___ $10,000.00 ___ $5,000.00 ___ $2,500.00 __ $1,000.00

(We can only accept donations in U.S. currency)

Total gift of: $

Monthly Donation

Total gift of $ paid in monthly installments of $

What is the billing information for the card you will be using? All required fields appear in bold. Your billing address must be entered exactly as it appears on your credit card please call 714-674-0391 for credit card payment.

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Address: _____________________________ City: ________________________ State: _____ Zip: __________

Phone:_______________ Email:______________________________ Website: ____________________________