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2015 Annual Campaign
100% of your donation to Girl Scouts of Hawai`i stays in Hawai`i –
together, we can make a difference in the lives of thousands of girls.
Donation Information
Amount:
...
$ 25.00
...
$ 50.00
...
$ 100.00
...
$ 500.00
...
$ 1,000.00
Other
$
*
Additional Information
Type of gift:
One-time gift
Recurring gift
Frequency:
Weekly
Monthly
Quarterly
Annually
On:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Starting:
Ending:
Ending:
Corporate:
This donation is on behalf of a company
Anonymous:
I prefer to make this donation anonymously
Comments:
Check all that apply:
Current Troop Member
Parent of Troop Member
Grandparent of Troop Member
Volunteer
Alumnae
Other
*
Billing Information
Title:
Ms.
Mr.
Mr. and Ms.
Miss
Dr.
Mrs.
Mr. and Mrs.
Admiral
Ambassador
Bishop
Brother
Captain
Chairman
Chancellor
Chaplain
Chef
Colonel
Councilmember
General
Governor
Judge
Madam
Major
Mayor
Pastor
President
Prof.
Rabbi
Representative
Reverend
Senator
The Honorable
The Reverend
Rear Admiral
*
First name:
*
Middle name:
Last name:
*
Country:
United States
Canada
United Kingdom
Australia
New Zealand
*
Address lines:
*
City:
*
State:
HI
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
CZ
DC
DE
FL
FM
GA
GU
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NL
NH
NJ
NM
NS
NT
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
NU
Hon
Ind
*
ZIP:
*
Phone:
Email:
*
Payment Information
Cardholder's Name:
*
Credit Card Number:
*
Card Type:
Visa
American Express
Discover
MasterCard
*
Card Expiration:
01
02
03
04
05
06
07
08
09
10
11
12
/
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
*
Card Security Code:
*
A Gift Of Stock
Required
I would like to donate a gift of stock (You will be contacted by a GSH staff member).
*
Required
First Name
*
Required
Last Name
*
Required
Please enter a valid email address with the format youraddress@yourdomain.
Email
*
Required
Address 1
*
Required
Address 2
*
Required
City
*
Required
State
*
Required
Please enter a 5-digit ZIP code or a 9-digit ZIP code with a hyphen after the first 5 digits.
Zip Code
*
Required
Please enter a 10-digit phone number. You can use hyphens or periods to separate numerals, and you can put the area code in parenthesis.
Phone Number
*
Required
Comment
*
Please click "Submit" for Gift of Stock
*