Donation Form


Your yearly membership is mostly welcomed. We assure you that the funds you are donating will be transferred in it's entirety to those that need your support. You will be notified by e-mail about our activates and our General Assembly that take place every February when we would like you to join us.

Please provide the following contact information:

First Name

 

Last Name

 

Street Address

 

Address (cont.)

 

City

 

State/Province

 

Zip/Postal Code

 

Country

 

Work Phone

 

Home Phone

 

E-mail

 

Choose one of the following options:

$100 Yearly Membership

If you like to make additional donation please enter the amount:

Choose one of the following options:

Visa
MasterCard
American Express

Enter your credit card number:

 

Expiry date:

 

Do you need tax receipt for your donation?

Yes No


Copyright © 2007 Stara Raska Foundation. All rights reserved.