AHC Donation Form

Your gift provides Vital Services, Education Programs and Summer Camp to low-income families, seniors and individuals living at AHC communities. Or, you may support the AHC Emergency Response Fund by selecting it below, under Gift Designation.

Fields with red asterisks (*) are required.

Gift Information

Gift Type

Use the drop down arrow above to schedule a recurring gift by having your card automatically charged this gift amount on an ongoing basis. You may increase, decrease or suspend your contributions at any time.

Gift Designation

This is a tribute gift.

Options

Please select Honor or Memorial

First Name

Last Name

If you would like us to notify someone of your gift:

Recipient First Name

Recipient Last Name

Recipient Address Line 1

Recipient Address Line 2

Recipient City

Recipient State

Recipient Postal Code

Recipient Country

Additional Notes:

My donation will be matched.

Options 2

Company Name

If this gift can be matched by your employer, please enter the company name here and complete and submit your employer’s matching gift form or online matching gift process.

Donor Information

I wish to remain anonymous. *

Company Name, if applicable

Title

Title Other...

First Name *

Last Name *

Suffix

Suffix Other...

Address Line 1 *

Address Line 2

City *

State *

Postal Code *

Country *

Email Address *

Phone *