CONTRIBUTION FORM

Name_______________________________________________________________

Address______________________________________________________________

City_________________________________________________________________

State___________________________ Zip_____________________________

Telephone Numbers______________________________________________

Enclosed is my contribution in the amount:

_____ $50	_____ $500
_____ $100	_____$1000
_____ $200	_____ $ ___________

Pledges above $500 may be paid in installments.

Please indicate preferred schedule of payments:

_____________________________________________________________________________

Make checks payable to: AACC

Print this form out and mail or fax to:

Mail: AACC

119 Sunnybrook Road

Raleigh, NC 27610

Fax: 919-212-3598

Thank you for your contribution!