Donation Form

"You must invent the future, or surely it will invent you."
-- Dr. Donald P. La Salle, Founder, Talcott Mountain Science Center

Thank you for your interest in supporting the Scholarship Fund
at the Talcott Mountain Science Center (TMSC).

We believe all students are entitled to an inspired education. Your gift today will provide much-needed tuition assistance for students in grades K-8 who would truly benefit from the hands-on, inquiry-based learning that only Talcott can offer.

Your gift will inspire today's children to invent tomorrow.

TMSC is a 501(c)3 nonprofit organization. All or part of your gift may be tax-deductible as a charitable contribution. Please check with your tax advisor.

* Required Fields

Donation Information

Amount

$100

$250

$500

Other

Type of Donation

One Time Donation
Recurring Donation

Frequency

Complete the following fields if this gift is a tribute. (optional)

Type of Tribute

Tribute Name

Title

First Name

Last Name

Address

Address 2

City

State/Province

Zip/Postal Code

Contact Information
* First Name
* Last Name
Company Name
* Address
Address 2
* City
* State/Province
* Zip/Postal Code
Home Phone
Cell Phone
Work Phone
* Email

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 Talcott Mountain and I will donate $0.00. No. I will donate $0.00 and Talcott Mountain will cover the processing costs.

Credit Card Information
Card Holder Name

Card Account Number
Expiration Date
* Security Code The 3 or 4 digit Security Code (CVV2) can be found on the back of your credit card. For American Express, the Security Code (CID) can be found on the front of the card.

Billing Address
Same As Above
* Address
City
State/Province
* Zip/Postal Code
Email

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.