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Donation
*
Mandatory fields
*
First name
Middle Name
*
Last name
*
Email
Phone
*
Address
*
City
*
State
*
Zip
Organization
*
Membership Level
Lifetime
Marie Watson Watkins $25
Thomas Paine $35
Clara Barton $50
Joseph Borden $100
Joseph Bonaparte $500
Legacy Silver $1000
Legacy Gold $2500
Legacy Platinum $5000
Please choose one
*
Preferred Method of Contact
Email
Mail
Society Interests
*
Amount ($USD)
Comment
Payment frequency
One-time
Monthly
Quarterly
Semi-annually
Annually
*
I would like my donation to go towards:
General Operations
Clara Barton
Do not wish to specify
Donation in honor of:
Please note the name of the person being honored with your donation
Honoree address and email
Please list honoree's address and email so your donation can be acknowledged
Donation in memory of:
Please note the person you are remembering.
In-Kind Donation
Clear selection
Yes
No
In-Kind Donation Amount
In-Kind Donation Description
Describe the type in in-kind donation
*
BHS acknowledgment of your donation on website
Yes
Prefer to remain anonymous
