Donor Information Company First Name Last Name Home Address City State - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code Email Address Phone Number Credit Card Donation All credit card donations will incur a 3% processing charge to offset the credit card processing fees. Thank You! Frequency of Your Donation One-Time Donation Recurring Donation (monthly) Recurring Donation (every 3 months) Recurring gifts will occur perpetually until you notify our office to stop payments. You may provide special instructions in the "Donor Notes" field below. One-Time Amount $10 $25 $50 $100 $250 $500 Other… Enter other… Monthly Recurring Amount $5/month ($5.15/month charged) $10/month ($10.30/month charged) $25/month ($25.75/month charged) $50/month ($51.50/month charged) $100/month ($103/month charged) $250/month ($257.50/month charged) Quarterly Recurring Amount $50/quarter ($51.50/quarter charged) $125/quarter ($128.75/quarter charged) $250/quarter ($257.50/quarter charged) $500/quarter ($515/quarter charged) $1000/quarter ($1030/quarter charged) $1,250/quarter ($1287.50/quarter charged) Donor Notes Payment Information
