Donation Form

SBHEC Donation Form

Thank you for your donation to the SBHEC. Please fill out this form and then hit submit to pay online. Please call (401) 453-7860 or contact Wendy Joering at wjoering@hercri.org with questions.
I would like to donate to *

Annual Fund Membership ($18)
Name *

First Name Last Name
E-mail *
example@example.com
Contact Number *
Billing Address *

Street Address

Street Address Line 2

City State

Zip Code
School Affiliation (if relevant)
Donation Amount *

$18 $36 $54 $108 Other
Calculation
Total Charge *

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USD A 3% credit card fee will be added to all transactions
Please add additional information here:
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SBHEC Donation Form