Monthly Gifting

 

You are on a secured server and may use your credit card with confidence

Your monthly financial commitment will make the greatest impact on our youth. Please complete the following secure form to make your contribution or call Development department at 602.271.9904.

This form allows you to securely set up automatic monthly donations and specify the day of month for them to occur.

Name:  
Company:

 

Employer

 

Occupation

 

Address:

 

City:

 

State:

 

Zip code:

Phone:

 

Fax:

 

Email:

 

Donation Amount:

 

How Often:

 

Start Date:   (YearMonthDay)
     
Credit Card Number  
Expiration Date   (MMYY)
     
Comments

 


You must initial each of the boxes below to meet federal contribution requirements:
This contribution is made from my own funds, and not from those of another.
This contribution is not made from general treasury fund of a corporation, labor organization or national bank.
I am not a Federal Government Contractor, nor am I a Foreign National who lacks permanent resident status in the United States.
This contribution is made on a personal credit card or debit card for which I have a legal obligation to pay, and is made neither on a corporate or business entity card nor on the card of another.

 


Tumbleweed Center For Youth Development - 1419 N. 3rd St. #102 Phoenix, Arizona 85004
Phone: 602.271.9904 | 24-hour crisis hotline: 602.841.5799 | Toll free number: 1.866.SAFE703