Donation Form

FOUNDER'S FUND PLEDGE/PAYMENT FORM

Please use the form below to complete your payment and pledge to Designs for Dignity as a Founder's Fund Member. ANNUAL minimum contribution is $200.00 and can be made as a one time gift of which 100% is tax deductible.

* Required Fields

Donation Information

Amount

Type of Donation

One Time Donation
Recurring Donation

Frequency

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 Designs For Dignity and I will donate $0.00. No. I will donate $0.00 and Designs For Dignity 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

In accordance with IRS regulations, this receipt confirms that no goods or services were received in exchange for this gift.

Designs for Dignity EIN: 26-2696975

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.