Holiday $30 for 30 Donation
Exit this survey

1. $30 for over 30 Years Donation Form

Please make a donation to MNADV in honor of a special person in your life!

Your $30 gift to MNADV in celebration of over 30 years, is a wonderful way to to honor - or remember - someone important to you. Tribute gifts celebrate a loved one or a special occasion, or simply remind someone special that they have been remembered in a thoughtful way.

*
1. Please enter YOUR contact information:

Please enter YOUR contact information: Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

2. Is your $30 donation honoring or remembering someone (please choose one):

Is your $30 donation honoring or remembering someone (please choose one): In Honor of Someone

In Memory of Someone

What is this person's name? This will be placed on the MNADV webpage.

3. Please indicate whether you would like the MNADV to send a notification of the donation?

Please indicate whether you would like the MNADV to send a notification of the donation? Yes, please send a card recognizing my gift.

No, please do not send a card.

4. Who should receive the recognition card and where should it be sent? (If you do not want a card sent, please leave this question blank.)

Who should receive the recognition card and where should it be sent? (If you do not want a card sent, please leave this question blank.) Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:

5. Would you like to include a personal message? If so, please write your personal message:

Would you like to include a personal message? If so, please write your personal message:

6. Please indicate your payment method?

Please indicate your payment method? I am donating $30 through Paypal (www.mnadv.org)

I am mailing a $30 check to MNADV, 6911 Laurel Bowie Rd, Ste 309 Bowie, MD 20715

Thank you for participating in our $30 for 30 Years campaign! Through your gift, you are helping MNADV works towards the elimination of domestic violence in Maryland.

Holiday $30 for 30 Donation Exit this survey