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General Donation
Your Information
Name
*
First Name
Last Name
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Email
*
Verify Email
*
Phone
Gift Information
Designation (optional)
select one
General/Meals
Pet Program
Amount
*
$5
-
Feeds 1 senior
$10
-
Feeds 2 seniors
$25
-
Feeds 5 seniors
$50
-
Feeds 10 seniors
$100
-
Feeds 20 seniors
$
Donation Schedule
One Time
Monthly
Yearly
I received a donation request at my home.
Mail Code (not your zip code)
Please type the code listed on your mailing slip. This code usually starts with an "R" or "D" and is found at the bottom of the donation slip. Example: R239SPA1 or D23SD326C.
Gift Options
Corporate Donations:
I'm donating on behalf of a company
Organization/Employer
Honorary/Memorial
I'm donating in honor/memory of someone
Tribute Type:
select one
In memory of
In honor of
Honoree or Memorial Name
First Name
Last Name
Notification:
Notify someone of my gift
Person to Notify (optional)
First Name
Last Name
Email of person to notify (optional)
Verify Email
Address of Person to Notify (optional)
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Message:
Include a personal message
Message (optional)
Example: "Happy Birthday Jane" (honorary) or "Sorry for your loss" (memorial)
Misc. (optional)
Receipt Options
I prefer a paper receipt sent to my home for each donation.
None, just send me a tax summary in January
Comments
Comments will be kept private unless specified.
I am interested in volunteering
Add 3% to my total to help cover card processing fees, and to make sure seniors receive more of my donation.
