MAKE A SPECIAL CONTRIBUTION TO AHHA


Use this form if...
  • You are currently an AHHA member and wish to make an additional contribution.
  • You are not currently an AHHA member and wish to make a special contribution without becoming a member.
GENERAL INFORMATION:
Full Name:
Organization:
Street Address:
City:
State:
Zip Code:
Country:
Office Telephone:
Home Telephone (optional):
E-mail (optional):
Web Site (optional):
This contribution is from an individual a company
ALL INFORMATION IS KEPT CONFIDENTIAL!

CONTRIBUTION INFORMATION:
$ I support AHHA with this special contribution
Special Notes:
You may designate this contribution towards a specific AHHA project or donate in honor of or in memory of a special person.
AHHA is a designated 501(C)(3) nonprofit - Tax ID# 33-041271
Contributions are tax deductible as allowed by law

SUBMITTAL OPTIONS:
(Option 1) To pay by check, money order or credit card by mail...
Click here for form to download, printout, complete and mail in.

(Option 2) To pay by credit card using online Secure Server...
AHHA accepts Visa, MasterCard and Discover
  • Fill in ONLINE on this screen all information requested above
  • Print out a copy of all of the above for your records
  • Click on Pay Online button below
  • Follow directions to enter and submit credit card data
To pay by credit card online, click the Pay Online button below.
You will be transferred to the Authorize.net Secure Server, and asked for your credit card information.
Once you have transferred to the secure server, you will be asked to...
Enter Credit Card Number and Expiration Date
Under "Customer Billing Information"
Enter Cardholder Name and Billing Address for Card
If you enter your E-Mail Address, you will receive an immediate e-mail notification of your transaction from the credit card operation.
AHHA will acknowledge your credit card transaction by notifying you of the authorization code.

Credit Card Processing