Holiday Credit Card Donation | Heartland United Way

Holiday Credit Card Donation Form

First

Middle

Last

Suffix

Address

City

State

ZIP Code

Preferred Email

Phone Number

Add dashes to phone number

Donation Recognition

My donation is in memory/honor of

Honor

Memory

Not Applicable

Honor of

Enter the name this donation is in honor of

Memory of

Enter the name this donation is in memory of

Designate my donation to:

Christmas Cheer

Holiday Toy Drive

Please keep my gift anonymous

Yes

For publication in The Independent, please list my information as follows: (EX. John & Mary Smith)

TOTAL

Amount of Credit Card Donation

Stripe