* required information
Assets Parents `Ohana
Dues & Donation Amount
Assets Parents `Ohana dues for the 2016-2017 school year is $50.00. If giving additional gift, add to dues and enter amount below.
:* $
Donor Information
Organization Name (if applicable):
Are there any instructions/comments that you would like to add?:
For recognition purposes, please type the donor name(s):
First Name:*
Last Name:*
Address Line 1:*
Address Line 2:
ZIP/Postal Code:*
Student Name:
Student Name:
Student Name:
Payment Information
Credit Card Type:*
Credit Card Expiration:*
Billing Information
If the billing information is the same as the contact information check this box.
If not please fill out the information below:
Type the characters you see in the picture below:*
By clicking Submit,
your credit card will be processed