Secure Server Donation Form

Please note that the fields with an asterisk (*) are required. You can use American Express, Discover, Visa or Mastercard with this form.

Title: Mr. Ms. Mrs. Miss Mr. and Mrs. Dr. Father Sister Brother Select One *First Name:  *Last Name:  *Street or P.O. Box:  Apt./Suite/Floor #:  *City:  *State:  --Select State-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware D.C. Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *Zip Code:  *E-mail:  Phone:

Designate my gift for:  Most Urgent Need   Foreign Missions   Care of Retired Sisters   Perú

You can select either a one-time contribution or a monthly contribution. As a monthly contributor, your gift will be automatically transferred to the Sisters every month until you stop or change the amount of your gift. A record of each contribution will appear on your bank or credit card statement. (Gifts will be processed on either the 1st of the month, or the 15th of the month, whichever is closer). Of course you can stop your monthly contributions, at any time, simply by notifying the IHM Development Office at donate@sistersofihm.org Monthly One-Time Select One

*Gift Amount $ .00

*Payment Type:   Credit Card   Check  If by Credit Card:  *Credit Card Type:  Visa Master Card American Express Discover Please select *Credit Card Number:  *Exp. Date:  January February March April May June July August September October November December / 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 If by Check:  *Checking Account Number:  *Routing Number:  Where do I find this?

I am interested in leaving the IHM Sisters in my will. Please contact me.  Yes   No  I have remembered the IHM Sisters in my estate plans.  Yes   No

If you were taught by IHM Sisters, please tell us what school you attended and your graduation year.

School Graduation Year

After ensuring that all the above information is correct, please click the "Submit Form Now" button ONLY ONCE

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Congregation of Sisters, Servants of the Immaculate Heart of Mary IHM Center 2300 Adams Avenue Scranton, PA 18509 570-346-5431 / 570-963-2482 Fax donate@sistersofihm.org