The South Dakota Coalition Against Domestic Violence & Sexual Assault

Become a Friend of the South Dakota Coalition Against Domestic Violence & Sexual Assault

Our goal is to eliminate abuse against women and children, both physical and sexual. Please join with us! Your donation will help bring the day closer when we will have peace in our homes and communities. Membership entitles you to our newsletter and will support the efforts to eliminate domestic violence and sexual assault across South Dakota. Please complete form, print it & send with your payment to the address below.

ORDER FORM

Select	Type of Membership		Price		Total
	Individual Membership	x		=
	Supporting Membership	x		=
	Contributing Membership	x		=

MEMBER INFORMATION:

Name:
Position/Organization
Address:
City:
State/Zip:
Phone:
Email:

Total Amount Enclosed:

Please send payment to:

South Dakota Coalition Against
Domestic Violence & Sexual Assault
PO Box 141
Pierre, SD 57501
or fax to:
(605) 945-0870