<p>Father’s Day Campaign Against Domestic Sign your name to be included in the Father’s Day Campaign completely within this box: We may use names and signatures, or just names, depending upon the number of participants.</p><p>Please print your name as you would like it appear in the ad. If you are a Religious Leader, Doctor or Judge, please also include your appropriate title.</p><p>Name ______</p><p>Address ______Street City State Zip Work phone ______Home Phone______</p><p>Email ______************************************* We also invite you to make a tax-deductible donation to the Protection From Abuse programs of the YWCA. You may also make a gift to the YWCA online. Please consider one of the following donation levels:</p><p>□ $1,000 – Hero □ $500 – Champion □ $100 – Defender □ $50 – Advocate □ $25 – Ally □ $10 – Good Guy □ Other______</p><p>I would like my contribution to support □ YWCA Battered Women Shelters □ YWCA AMEND Program for male abusers</p><p>Enclosed is my □ Check payable to the YWCA of Greater Cincinnati □ My credit card number to be charged:</p><p>Card Type______Expiration ______</p><p>Card Number______</p><p>Signature______</p><p>Print, scan and email to [email protected] Fax to YWCA at (513) 361-2153 or Mail by June 8th to: Father’s Day Campaign YWCA of Greater Cincinnati 898 Walnut Street Cincinnati, OH 45202</p>