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Donor Information

First Name

Last Name

Home Address

City

State

Zip Code

Email Address

Phone Number

Credit Card Donation

Would you be willing to cover the 3% online processing fee?

Yes

No

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

$25

$50

$75

$100

$250

$500

$1000

Other…

Please enter your amount $

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)

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

$25

$50

$75

$100

$250

$500

$1000

Other…

Please enter your amount $

Monthly Recurring Amount

$5/month

$10/month

$25/month

$50/month

$100/month

$250/month

Quarterly Recurring Amount

$50/quarter

$125/quarter

$250/quarter

$500/quarter

$1000/quarter

$1,250/quarter

Donor Notes

Would you like to designate your gift?

Yes

NO

Please specify where you want your gift to go:

Payment Information

Prefer to write a check?

All checks can be mailed to: 7720 NC Hwy 22, Carthage, NC 28327

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7720 NC Hwy 22
Carthage, NC 28327
(910) 949-4045

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