The Oley Foundation Secure Online Donation Form

Secure Online Donation Form

Please note that fields with an asterisk (*) are required.
International donors do not need to select a State or enter a Zip Code.
For your security, this form will not work if you use the AutoFill feature in your browser.

*First Name:
*Last Name:
*Address 1:
Address 2:
*City:
State (Not required for International Donors)*:
Zip Code (Not required for International Donors)*:
*E-mail:
*Daytime Phone:
Evening Phone:

If you live outside the United States. Please complete the following section as well.
Country:
Province/Territory:
International Phone #:

My donation is in honor of:

My donation is in memory of:

International Donors:
All donations are made in U.S. Dollars.
Your credit card bank may assess additional fees for currency conversion and processing.

You can use this tool to help you estimate your donation in U.S. Dollars
The Universal Currency Converter Services

*Frequency:

*Donation Amount: $ .00

*Credit Card Type:
*Credit Card Number:
*Exp. Date:	/

After ensuring that all of the information above is correct,
please click the Submit Form Now button ONLY ONCE.
Multiple clicks of the Submit button will result in duplicate charges to your account.
An e-mail confirmation will be sent to the e-mail address you provided.

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