DONATION FORM

Phone: (724) 850-6874
Fax: (724) 850-6875

Thank you for your interest in CASA of Westmoreland. If you would like to consider making a contribution now, please fill in the fields below, then press "Submit My Donation."

This gift is from:

661-555-5555

Donation Types

  1. Leadership Breakfast
  2. Membership
  3. In Honor Of
  4. In Memory Of
  5. General
  6. 14"x14" Plate
  7. 9"x9" Plate
  8. 5"x10" Plate
  9. Travel Mug
  10. License Plate Cover
  11. Golf Towel
  12. T-Shirt Small
  13. T-Shirt 2XLarge
$10 $25 $50 $100 Other

Please notify the following person that this gift has been made to CASA of Westmoreland

661-555-5555

Please check that all parts of the form above have been completed and then press "Submit My Donation" only once. The confirmation page will appear shortly afterwards. Then you will be able to proceed through paypal paying via Credit Card or Paypal account (not required for payment) to complete the process.

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