Wheelchair Foundation

Secure One-Time or Recurring Donation

Your Donation

Please select the type of donation and the amount you would like to donate.

$150 donation manufactures and delivers one new wheelchair (valued at $500 US) and a new sense of freedom to a person in need.

I would like to make a one-time gift for the following amount:

Here's my one time gift amount: if other:

I would like to make a monthly recurring gift for one year.

Recurring Amount: if other:

Credit Card Information

Please enter the credit card information.

Card Type: *

Credit Card #: *

Expiration Date: *

Name as it appears on card: *

Donor's Mailing / Billing Information

Please enter Mailing information. Your billing information must EXACTLY match the address printed on your billing statements.

First Name: *

Last Name: *

Address: *

City: *

State/Province: *

Zip/Postal Code: *

Country: (if outside USA)

Email Address: *

Company: (if applicable)

Yes, Billing Information MATCHES Mailing Information

Please enter Billing information.

First Name: *

Last Name: *

Address: *

City: *

State/Province: *

Zip/Postal Code: *

Country: (if outside USA)

I would like to receive a presentation certificate for my gift of $150 or more Yes No

Presentation Certificate Information

The Wheelchair Foundation Wishes To Thank:

For The Gift Made In The:

Presentation Folder Mailing Address

Address:

City:

State/Province:

Zip/Postal Code:

Country: (if outside USA)

How did you hear about Wheelchair Foundation?

Describe:

Share a comment with the Wheelchair Foundation

Comment:

The Wheelchair Foundation is a Division of Global Health and Education Foundation. It is a 501(c)3 charitable foundation and the Federal Tax ID is 94-3353881.

Wheelchair Foundation

Secure One-Time or Recurring Donation

Your Donation

Please select the type of donation and the amount you would like to donate.

Credit Card Information

Please enter the credit card information.

Donor's Mailing / Billing Information

Please enter Mailing information. Your billing information must EXACTLY match the address printed on your billing statements.

Please enter Billing information.

Presentation Certificate Information

Presentation Folder Mailing Address

How did you hear about Wheelchair Foundation?

Share a comment with the Wheelchair Foundation

© Copyright 2008 Wheelchair Foundation. All rights reserved.

The Wheelchair Foundation is a Division of Global Health and Education Foundation.
It is a 501(c)3 charitable foundation and the Federal Tax ID is 94-3353881.

website design : www.brandnavigation.com

Other Wheelchair Foundation sites