YES, our Credit Union wants to participate in the national credit union initiative to raise funds for the hospitals in the Children’s Miracle Network. We agree to have PSCU Financial Services act as an agent on our behalf and donate to the Children's Miracle Network 1% of our credit union’s credit and/or debit card interchange revenue collected for the months designated below.  (Your monthly interchange revenue appears on the FM-001 report.)

Donate 1% Credit Card Interchange Donate 1% Debit Card Interchange Donate Both Credit and Debit Card Interchange

Donation Months (check all that apply)

November 2009 December 2009 January 2010 February 2010 March 2010 April 2010

No , our credit union will be unable to participate.

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