Mail To: ADVANTAGE BUSINESS CENTER ATTN: AURITON SOLUTIONS 635 PRIOR AVE N STE 3 ST PAUL, MN 55104-9810 _________________________________________________________________________ Name (as it appears on your check or credit card) _________________________________________________________________________ Address _________________________________________________________________________ City, State ZIP _________________________________________________________________________ Phone _________________________________________________________________________ Signature I understand that my monthly gifts will be transferred from my bank account or credit card for 12 months. I also understand that I may discontinue my monthly contributions at any time by contacting Auriton Solutions at 800-253-5076. I will make a one-time contribution of: $_________________ I will make 12 monthly contributions of: $_________________ I would like my monthly gift to be transferred from my bank account or credit card on:________ (day of the month) Enclosed is a check for my first monthly gift. I understand that my future monthly gifts will be transferred directly from my bank account for the same amount. Here is my VISA, MC, Amex or Discover credit card account information. I understand that my future monthly gifts will be transnferred directly from this credit card. _________________________________________________________________________ Credit Card Number _________________________________________________________________________ Expiration Date