Donation Form

Donation Information

Instructions This form is used to collect online donations for many different purposes. Enter the AMOUNT of your donation.TYPE OF DONATION refers to a one time donation or a recurring donation that you'd like us to process on a monthly basis - you choose. DONATION PURPOSE is set with a pull down menu. Please select the reason for your donation; ex. Annual Fund, a Gift in Memory of someone, etc. You can use the GIFT MEMO/DETAIL box as a text box to tell anything else you would like to explain. If your gift is a tribute, please use the TRIBUTE SECTION to give us this information. We are deeply grateful for all of your gifts!

Amount

Type of Donation

One Time DonationRecurring Donation

Donation Purpose - Please choose one

Gift Memo/Details

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

Type of Tribute- Please choose one

Tribute Name

Title

First Name

Last Name

Address

Address 2

City

State/Province

Zip/Postal Code

Donor Contact Information

First Name

Last Name

Address

City

State/Province

Zip/Postal Code

Home 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 Virginia Thurston Healing Garden and I will donate $0.00.No. I will donate $0.00 and Virginia Thurston Healing Garden will cover the processing costs.

Credit Card Information

Card Holder Name

Card Account Number

Expiration Date

Security Code
Click here for CVV2 information

Billing Address

Same As Above

Address

City

State/Province

Zip/Postal Code

Privacy Policy
We keep your personal information private and secure. When you make a payment through our site, you provide your name, contact information, payment information, and additional information related to your transaction. We use this information to process your payment and to ensure your payment is correctly credited to your account.