Donation Form

Christopher's Haven touches people’s lives in unimaginable ways. It is their home away from home when their child or grandchild is receiving life saving cancer treatment. It is not just a place to stay. It is a place to return to after a hard day, and share experiences with people living similar nightmares. It is a happy place actually, filled with love, support, activities, volunteers, and warmth. It contributes to the healing process while going through treatment and long afterwards. It is family centric, caring not only for the patient, but the entire family unit. There are many people who’s lives have been touched by Christopher’s Haven, and they and their families would like an opportunity to give back financially to help support the organization.

Donation

Amount

$500

$250

$50

I would like to dedicate this donation

Contact Information

First Name

Last Name

Company Name

Address

Address 2

City

State/Province

Zip/Postal Code

Home Phone

Cell Phone

Work Phone

Help Us Cover Costs

Simply leave "Yes!" checked below to ensure that 100% of your intended donation is available for our mission.

Yes! I want $0.00 to go to Christopher's Haven and I will donate $0.00.No. I will donate $0.00 and Christopher's Haven will cover the processing costs.

Credit Card Information

Card Holder Name

Card Account Number

Expiration Date

Security Code

Billing Address

Same As Above

Address

City

State/Province

Zip/Postal Code

Privacy Policy
We take precautions to protect your information. We collect credit card or bank account information, names, addresses, and other data related to your transaction when you make a payment through our site. We use this information to process your payment.

Terms/Conditions
By submitting your payment, you authorize us to charge the account above for the amount specified in the Transaction Amount field. Account information for Recurring Pledges/Monthly Giving is encrypted and stored securely via SafeSave™ for automatic processing of your future payments. Notify us at anytime if you wish to discontinue your pledge.