Amount

$72
$100
$180

$360
$500
$1000

$1800
$3600
Other Amount

Recurring donation
Please charge the above amount to my credit card each month for the next twelve months.

Optional Dedications
In Memory of
Make a donation in memory of a deceased family member or friend.		 In Honor of
Make a donation in honor of someone or to celebrate a joyous occasion.		 Details
Please direct my contribution towards

Please contact me to discuss additional giving opportunities
Contact Details
Title
First & Last Name
Address
City, State & Zip
Phone
Email
Address Type
This is my home address This is my business address

Acknowledgement
Please acknowledge my gift to my email address Please acknowledge my gift to my street address

Credit Card Details
Card Number
Card Type
Card Code
Expiration Date
Comments

This organization is a 501(c)3 tax exempt organization - All Donations are tax-deductible.