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The Know Now Foundation “Direct Purchase & Gift” Form

Pre-registration as a KNF Ambassador Required


The Know Now Foundation “Direct Purchase & Gift” program is purposed for providing registered
Know Now Foundation Ambassadors (KNFA) direct access to Breast Chek Kits at the KNF direct
price of $30 USD each. Purchases may be gifted directly to KNF or shipped to the purchaser for
gifting or fundraising. Purchases may be made on a one-time, monthly, or, as needed basis. The
Know Now Foundation accepts gifts of Breast Chek Kits only.

100% of all BCKs gifted directly to “The Know Now Foundation” are delivered to nonprofit and
charitable organizations where they are gifted to women at risk. To make your contribution
even more meaningful, KNF will include a “50% Matching Gift” on purchases gifted
directly to KNF. For example, your gift of 10 Breast Chek Kits will create a total gift of 15
BCKs! Please note the matching gift program applies ONLY to direct gifts to KNF and not to
purchases shipped for gifting or fundraising.

For monthly purchasers, the transaction will be executed every month on or about the date of
signature. Payment for one-time donations will be executed upon receipt. To participate please
complete, sign, and fax this form to: +1-480-998-3582 (International) / 1-877-281-8322 (USA)

KNFA & Purchase Information


__ Please accept my purchase as a direct gift to KNF and include the KNF 50% Matching Gift
__ Please ship my purchase to the address below (Shipping charges will apply)
__ Monthly Gift (This transaction WILL be automatically executed on a monthly basis)
__ 1-Time Gift (This transaction will NOT be automatically executed on a monthly basis)

_____________________________________________________________________________
Your Registered KNFA Identity

_____________________________________________________________________________
Shipping Address Number & Street City State/Province Zip/Postal Code

__ 4 Breast Chek Kits $120 USD + shipping if not a direct gift to KNF
__ 8 Breast Chek Kits $240 USD + shipping if not a direct gift to KNF
__ 12 Breast Chek Kits $360 USD + shipping if not a direct gift to KNF
__ 20 Breast Chek Kits $600 USD + shipping if not a direct gift to KNF
__ 20+ Breast Chek Kits Please call customer service: 480-998-3490, Ext 3

Credit Card Type qVisa qMasterCard qDiscover qAmerican Express

Credit Card Number _________________________________________________

Exp ____/____/____ CVV Code: _______ (3 or 4 Digit Code on Credit Card)

__________________________________________________________ ____/____/____
Authorized Signature Date of Signature

THANK YOU for your generous gift and for moving the KNF MISSION forward!
To PAY BY CHECK mail to: (Please make payable to Plexus Worldwide, Inc.)
Plexus Worldwide, Inc., 7025 E. Greenway Parkway, Suite 250, Scottsdale, AZ, 85254