Jim Goes To Haiti Donation
Please complete the information below so that we may provide a donation receipt for tax purposes. Thank you for your support!
Receipt Preference:
*
Emailed
Mailed
No Receipt
Name
*
First Name
Last Name
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Special Instructions/Note to Jim:
Click “Submit” to continue to Friar Suppliers’ secure donation site. Thank you!
Submit
Should be Empty: