To make a donation to the ACCESS Academies, please fill out the form below.
[stripe name=”Friends of the Academies” billing=”false” payment_details_placement=”below”][stripe_text label=”First Name:” id=”first_name” required=”true”] | [stripe_text label=”Last Name:” id=”last_name” required=”true”] |
[stripe_text label=”Email:” id=”email_address” required=”true”] | [stripe_text label=”Phone:” id=”phone_number” required=”true”] |
[stripe_text label=”Street Address:” id=”street_address” required=”true”] | [stripe_text label=”City:” id=”city” required=”true”] |
[stripe_text label=”State:” id=”state” required=”true”] | [stripe_text label=”Zip Code:” id=”zip_code” required=”true”] |
Example Donation Amounts: ($35, $60, $100, $250, $500 or custom amount)
[stripe_amount label=”Enter your donation amount” options=”$35,$60,$100,$250,$500″ amounts=”3500,6000,10000,25000,50000″] |
Please give the charity my:
[stripe_checkbox default=”true” label=”Name”]
[stripe_checkbox default=”true” label=”Email”]
[stripe_checkbox default=”true” label=”Mailing Address”]
Dedicate my donation:
[stripe_text label=”In the name of:” id=”honorees_name” required=”false”]
or
[stripe_text label=”In memory of:” id=”deceaseds_name” required=”false”]