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Monthly General Donation Form
Hello! You are donating between our twice a year Fund Drives. Thank You!
Our donation Premiums (Shirt, scarf, mousepad, etc) are limited edition, and created for each drive. We will send you the appropriate level Premium for this donation when we have our next Fund Drive, and each Drive going forward.
Donation Amount & Premium. Includes Shipping!
$100
-
Shirt + Next Level + PIF
$61
-
Shirt + Next Level + PIF
$51
-
Shirt + Next Level
$41
-
Shirt + Next Level
$31
-
Shirt + Next Level
$21
-
Shirt + Next Level
$11
-
Shirt
$
Your gift will be made
Monthly
Premiums?
*
Yes! I want my Donation Level Premium (Shirt, Scarf, Mousepad, etc.)
Not needed, I'll skip receiving a premium for my support
Shirt Size
*
Small
Medium
Large
X-Large
XX-Large
XXX-Large
XXX-Large Tall
XXXX-Large Tall
Contact Information
Name
First Name
Last Name
-- and/or -- Organization Name
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Email
*
Verify Email
*
Employer Match
Yes - My employer matches gifts!
No
Employer
Questions
Email: fundraising@wrir.org
Add 3% to my total amount to help cover the payment processing fees