HFLA Online Donation Form

HFLA Online Donation Form
Is this a Personal, Corporate or Foundation Gift?

PersonalCorporateFoundation
Donor Name:*

First NameLast Name
Name of Corporation for Donation Receipt:
Name of Foundation:
Name of person completing this form: *

First NameLast Name
Donor Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Donor Email:*
example@example.com
Donor Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.
Where would you like your donation designated to?
Please provide the name of the loan fund you would like this donation designated to:
Would you like to send a tribute card to someone for this donation?

Yes, please send an e-card tribute on my behalfYes, please send a physical tribute card on my behalfNo thank you
Tribute Card Recipient's Name:

First NameLast Name
Tribute Card Recepient's Email address:
example@example.com
Would you like us to include the name of the fund you are designating your gift to on this tribute card?*

YesNo
Tribute Card Recipient's Mailing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Tribute Card Message to Recipient:
Do you give us permission to recognize your support on our website or other materials?*
How much would you like to donate to HFLA?*

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