I would like to become a Friend of Safe Places to help children exposed to violence and abuse find safety and protection, and to help families create homes free of violence and abuse.
THREE PAYMENT METHODS FOR YOUR CONVENIENCE:
1. I have enclosed a personal check made out to Safe Places.
$10 $15 $20 $25 $40 $50 Other amount $ ________________
2. I would like to charge my monthly contribution to my credit card.
Monthly Pledge Amount: $ ____________________ (Minimum $10)
I want to charge my contribution to my: MasterCard VISA American Express Discover
Credit Card No. _____________________________________________________ Expiration Date: ______________________
Name as it appears on card: _____________________________________________________
Signature: ____________________________________________ Date:___________________
Daytime phone number:_________________________________________________________
3. To make a monthly contribution through electronic funds transfer from your bank account, simply download a Direct Debit Agreement Form, print, and mail it with a voided check to:
Safe Places Business Office
2607 Lehigh Drive
Little Rock, AR 72204
Click this link to download the Direct Debit Agreement: