The
Cardinal Kung Foundation

Mr. & Mrs.          Mr.          Mrs.          Ms.          Miss         Dr.          Rev.          Other                 

First Name                                                Middle                 Last Name                                                Suffix:                

Title:                                                                         Company:                                                                                            

Address:                                                                                                                                                                                 

City                                                                                            State                Zip                           Country                    

(Optional)  Telephone:                                                           E-mail:                                                                                

Apply my donation to: General Fund          Specific Program:                                                                                     

Other:                                                                                                                                            

A)  Donation without pledge:    Amount   $                           Check enclosed               Bill me later            

B)  Donation with pledge:   My pledge is for $                      Check enclosed $              Please bill me for 

the balance of $                         in              (1-10) equal payments to be paid       monthly,        Bi-monthly, 
or           quarterly beginning on                                  (date). 

(Sorry, we cannot accept credit  cards at this time.)

Signature:                                                                                                                       Date:                                

I found your website from:

£  Search Engine: (name)                                                 £ Newspaper:  (name)                                            

£ Friend's Recommendation              £ Other:                                                                      

Please mail to: The Cardinal Kung Foundation, PO Box 8086, Stamford, CT  06905