Recurring Donations

Monthly Supporter

Set up an automatic recurring donation by choosing a plan or entering your own amount. Payments are managed securely by our payment provider.

Recurring Amount

$10 Monthly

$10.00 for each month

$25 Monthly

$25.00 for each month

$50 Monthly

$50.00 for each month

Custom Amont

USD for each month

Email

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Donation Notes
Is this in memory, in honor or in recognition of anyone?
By selecting a recurring donation, you authorize Waterbury Ambulance Service to securely charge your payment method through our payment provider on a recurring monthly basis in the amount you selected until canceled.

You may cancel your recurring donation at any time by using the link: Stripe Customer Portal

Or by contacting us at info@waterburyambulance.org | 802-244-5003.

No refunds will be issued for processed recurring donations but your cancellation will take effect immediately.

Receipts will be emailed directly through our payment provider. Contact us if you do not receive these.
Signature
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