Telephone #: Name: E-mail: Address: City: State: Zip: Organization: Donation Amount: Credit Card Type:   Visa   AMEX  Mastercard Credit Card Number:  Expiration date: If you prefer, you may print this form and submit by mail or fax. Checks or money orders made out to the Illinois Bar Foundation. VISA/Mastercard/AMEX accepted. Illinois State Bar Association 424 South 2nd St. Springfield, IL 62701 Attn: Katrina Relief Fund FAX (217)525-0712