Donation Form

Presenting opera, songs, and chamber music for over a decade!

Sunday, October 22nd, 2017 from 3-5 PM

Park Avenue Congregational Church- 50 Paul Revere Rd, Arlington, MA

Admission is free - please make a donation to support The Accelerated Cure Project for MS

* Required Fields

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

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 Accelerated Cure Project and I will donate $0.00. No. I will donate $0.00 and Accelerated Cure Project 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 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.

Contact Us: Accelerated Cure Project for MS •• 460 Totten Pond Road, Suite 420, Waltham, MA 02451 •• 781-487-0008 •• [email protected]