YOUR GIFT AMOUNT

Total Gift

Total Gift

This gift will be processed immediately.

The same amount will then be recurrently processed starting on the date selected, until the subscription is modified or cancelled.

For example: Johnny Smith, Sue Smith's Birthday, etc.

Recipient Information
1000 characters left

Please spell check, include how you would like your name(s) signed, mention the amount if desired, and format your message as you would like it delivered.

Payment Details
Credit Card

Processing

Total Donation:
Your Information
Middle Initial
    Please verify your address. To ensure accurate processing, consider the suggested changes below.
      500 characters left
      Leave this blank

      Thank you for your contribution. We are so thankful.

      Your transaction is secure. Learn More.
      If you would like to access this form on its own page, please click here.

      Transaction Security

      Is my donation secure?

      The security and confidentiality of your information is our highest priority. We use industry-standard SSL (secure socket layer) technology to protect your information and provide a safe and secure environment for online donations. We will not sell, trade or share your personal information with anyone else, nor send donor mailings on behalf of other organizations.

      About This Form

      Access Services has partnered with RaiseDonors to assist in the processing of donations.

      Access Services
      http://www.accessservices.org
      marketing@accessservices.org
      215-540-2150
      500 Office Center Drive, Suite 100
      Fort Washington, Pennsylvania 19034
      US

      To access this form on its own page, click the link below:
      Intersect Donation

      About RaiseDonors

      RaiseDonors is the simple, secure and affordable way to accept donations online.

      RaiseDonors, LLC
      raisedonors.com
      PO Box 488
      Coppell, Texas 75019
      United States

      Back to Donation Form