Instructions:  Print out, complete and mail in this form with your donation (PDF).

I wish to help the Smithsonian Asian Pacific American Program bring the first Vietnamese American exhibit to the Smithsonian by making a

__ Donation (pay now)

__ Pledge (pay later but all funds must be received by June 30, 2005)

Amount:

Name:

Address:

Email:

Telephone:

Name for Acknowledgement Purposes:

1. __ I would like to make my donation by check

Please make check payable to Smithsonian Asian Pacific American Program and mail to:

Gina Inocencio

Program Specialist

Smithsonian Asian Pacific American Program

A&I, Room 2467, MRC: 440

P.O. Box 37012

Washington, DC 20013-7012

2. __ I would like to make my donation by credit card (you can call us and provide your number over the phone or via fax (202-633-9047) if you don’t want to use the mail)

Credit Card number:

Name on Credit Card:

Expiration Date:

3. __ I would like to pay my pledge in installments (Staff will contact you)

For more information, please contact Francey Youngberg, Development Consultant at Francey.youngberg@verizon.net. You can also call the Smithsonian APA office at 202-786-2409 and speak with Franklin Odo or Gina Inocencio. Also, to check out prior APA exhibits and programs, visit www.apa.si.edu.