Board Giving Donation

My/Our commitment will be made in the following manner

Payment method

Gift Amount

Checks can be mailed to: Division of Generosity and Impact - 6770 102nd Ave N., Pinellas Park, FL 33782

My Pledge Amount to be fulfilled by 12/31/2026

My gift of

USDMy Board Commitment

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Gift Amount

The Division of Generosity and Impact will be in contact to assist you.

Donor Recognition/Anonymous

For recognition, I/we would like my/our name(s) to appear as:

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.

Email

example@example.com

EMPATH-STRATUM, INC., CH78002. A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (800-435-7252) WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.

🔒 All payments are processed through a secure, encrypted system to protect your information.

My Annual Gift Commitment

My gift of