2015 Annual Campaign - Girl Scouts-Hawaii

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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:

On:
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:

*

First name:

*

Middle name:

Last name:

*

Country:

*

Address lines:

*

City:

*

State:

*

ZIP:

*

Phone:

Email:

*

Payment Information

Cardholder's Name:

*

Credit Card Number:

*

Card Type:

*

Card Expiration:

/

*

Card Security Code:

help

*

A Gift Of Stock

Required

I would like to donate a gift of stock (You will be contacted by a GSH staff member).

*

RequiredFirst Name*

RequiredLast Name*

RequiredPlease enter a valid email address with the format youraddress@yourdomain.Email*

RequiredAddress 1*

RequiredAddress 2*

RequiredCity*

RequiredState*

RequiredPlease enter a 5-digit ZIP code or a 9-digit ZIP code with a hyphen after the first 5 digits.Zip Code*

RequiredPlease 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*

RequiredComment *

Please click "Submit" for Gift of Stock*

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