Friends of St. Dominics Home Secure Online Donation Form

I want to contribute to the Friends of Saint Dominic's, the affiliated
fundraising organization supporting the work of Saint Dominic's Home.


You may use Visa, Mastercard, American Express, or Discover *Required Fields

Title: 
*First Name: 
*Last Name: 
*Street or P.O. Box: 
Apt./Suite/Floor #: 
*City: 
*State: 
*Zip Code: 
*Daytime Phone: 
Evening Phone #: 
*E-mail: 

You may select a One-time, Monthly or Quarterly recurring contribution. As a recurring contributor, your gift will be automatically transferred to Friends of Saint Dominic's until you stop or change the amount of your contribution. A record of each contribution will appear on your credit card or bank statement. You can discontinue recurring contributions at any time by contacting Friends of Saint Dominic's at
845-359-3400 Ext.320 or by e-mailing nriefberg@sdomhome.org

*Gift Amount $:  .00
*Gift Frequency: 


*Payment Type:   Credit Card   Check 

If by Credit Card: 

If by Check: 
*Credit Card Type: 
*Credit Card #:  *Routing #:  Where do I find this?
*Exp. Date:  / *Checking Account #:  Where do I find this?



Comments:



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 email confirmation will be sent to the email address you provided.


 

  
Friends of Saint Dominic’s, Inc.
500 Western Highway • Blauvelt, NY 10913 • Phone: 845-359-3400 • Fax: 845-398-0466
Send us an e-mailwww.stdominicshome.org


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