| Print this page | 
 | 
 | NAMI HOME | SIGN IN
NAMIWALKS for the Mind of America
NAMI Secure Online Area--Credit Card--Donation Form
Make a secure online donation to support Dean Deurwaarder's participation in NAMIWALKS in Portland, OR on Sunday, May 23, 2010. Choose an amount and pay with your credit card below.

I am making a donation of:

 
$500 $100 $50 $35 Other $
Title
First Name*
Last Name*
Suffix
Address Line 1*
Address Line 2
City*  
State/Province/Other*
Zip/Postal Code*
Country
Email Address*
Daytime Telephone
Company
 
 
 
  MasterCard, Visa, American Express, and Discover Card accepted
Card Type*
Card Number*
Card Expiration*  
Cardholder Name*
Card Security Code* (what's this?)
Message for Dean Deurwaarder:

spacer
Your donation amount and comments will be listed on this Walker's public Web page. If you wish your name to be listed as 'Anonymous', please check here:

spacer


spacer
Please click "Submit Donation" one time only. Clicking this button more than once may result in double billing. Processing usually takes at least 10 seconds.

* These fields are required. Not filling in these fields will result in an error.


Contributions are tax deductible to the extent permitted by law.

NAMI truly appreciates your gift to help others.

You've made a difference!

If you have questions or comments regarding your donation,
please contact donorservices@nami.org or 1-888-999-NAMI (6264), option 3.




 | Print this page | 
 | 

©2010, NAMI - National Alliance on Mental Illness. All rights reserved.