Donation Form

 

Alayah Foundation

 

Donor Information (please print or type) and mail it or email to the address listed at the bottom of this page.

Name

 

Mailing address

 

City

 

State

 

ZIP Code

 

Telephone (home)

 

Telephone (business)

 

Fax

 

E-Mail

 

 

Pledge Information

I (we) pledge a total of $to be paid:
now monthly quarterly yearly.

I (we) plan to make this contribution in the form of:
cash check credit card other.

For credit card or e-check payments, please use our website donation link. This link will take you to the safe and secure PayPal website.

Gift will be matched by (company/family/foundation).
form enclosed form will be forwarded

Acknowledgement Information

Please use the following name(s) in all acknowledgements:

 

I (we) wish to have our gift remain anonymous.

Signature(s)

Date

Please make checks, corporate matches, or other gifts payable to:

Alayah Foundation

1746-F South Victoria Ave #316

Ventura, CA 93003

Fax: (815) 352-0133

Email: donation@alayahfoundation.org