Total: $0.00


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Thank you for supporting the Longmont Humane Society!
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General Donation Form
Select Gift Frequency
I would like to make a one-time gift for the following amount:
:* $
I would like to make a recurring gift.
Gift Amount* # of Payments Payment Frequency Total Gift Amount
$ X = $
NOTE: Each payment, including the first payment, will be made on day 15 of the month based on the payment frequency you have indicated.
Donor Designations
Select a designation for your contribution*
Donor Information
First Name:*
Last Name:*
Address Line 1:*
Address Line 2:
ZIP/Postal Code:*
My family includes:
Payment Information
Payment Method
:*   Explain
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:
Additional Information
Tribute Type:
Tribute Name:
Acknowledgement Letter Name:
Acknowledgement Letter Address 1:
Acknowledgement Letter Address 2:
Acknowledgement Letter City:
Acknowledgement Letter State:
Acknowledgement Letter Zip:
Type the characters you see in the picture below:*
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