Thank you for your support of Independence House.
Please use this secure payment form to complete your transaction.
Donation
Donation Type:
$25.00  
$50.00
$75.00
$100.00
Enter Other Amount $  
Sub-Total $
I would like my donation to recur:
Do you have matching funds available?
If Yes or Not Sure, who will be matching?
This donation is a join gift from myself and:
This donation is in tribute to:
I wish to donate anonymously:
I would like to receive your newsletter:

  

Payment processing is Powered by
the Elavon Global Payment Solutions Network.
Information collected is protected by the latest
in SSL encryption, so you can make a transaction with confidence.

Questions or comments? Please contact Independence House
by phone 508-771-6507 or email indhouse@indhouse.net

Privacy Policy Statement: Your personal information will
not be shared with anyone other than Independence House
and the payment processor to securely process this transaction.
Independence House, Inc. - Donation Page

Please review the following information.
Use the Back button on your browser to make any changes.

Donation
Appeal 25.00
I would like my donation to recur: No Thanks
Do you have matching funds available? No
If Yes or Not Sure, who will be matching?
Sub Total 25.00
Grand Total:  $25.00

 
Cardholder Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City: 
* State: 
* Zip / Postal Code:    
* Country: 
* E-mail Address:
* Phone:
 
 
Credit Card Information
Credit Card Type Accepted:
* Credit Card #
Card Security Code: what is this?
* Expiration Date:  Month  Year
 
 
     

Payment processing is Powered by
the Elavon Global Payment Solutions Network.
Information collected is protected by the latest
in SSL encryption, so you can make a transaction with confidence.

Questions or comments? Please contact Independence House
by phone 508-771-6507 or email indhouse@indhouse.net

Privacy Policy Statement: Your personal information will
not be shared with anyone other than Independence House
and the payment processor to securely process this transaction.