Donation Form

* Required Fields

Donation

Amount

$500.00

$250.00

$50.00

Other

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

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.

DSAMn Refund Policy
After payment has been made for event/class/program:

14+ Days Prior* to start date of event: 100% Refund

8-14 Days Prior* to start date of event: 50% Refund

Less Than 7 Days Prior* to event: No Refund can be Provided

DSAMn classes need a minimum enrollment to run. We may need to cancel low-enrollment classes. If you register for a class that is cancelled you will notified and fully refunded within 5 business days of cancellation.

Program Scholarships and Financial Support

Cost should not be a barrier to participation in any DSAMn program. All our programs are offered on a sliding fee scale based on Federal Poverty Level Guidelines. Families living at or below 200% if FPL are eligible for the sliding scale.
If fees are an issue for any family even if you do not meet the guidelines above, please email [email protected] - we can help.