Donation Form

Donations are made in honor of Dr. Ann St. Amand, who shared her love of science with the youth of Benton Harbor.

We will notify the family of your contribution in her memory.

Your contribution is tax-deductible as allowable by federal and state tax laws. The Boys & Girls Clubs of Benton Harbor is a 501(c)3 not-for-profit organization registered in the state of Michigan. Federal tax identification is #38-3461586.

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 Boys and Girls Club of Benton Harbor and I will donate $0.00.No. I will donate $0.00 and Boys and Girls Club of Benton Harbor will cover the processing costs.

Payment Information

Payment Options

Credit Card Information

Card Holder Name

Card Account Number

Expiration Date

Security Code

Billing Address

Same As Above

Address

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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.