CHWC 2022 Donation Form

Donation Form

 

Thank you for donating toward the BOLD trip to CHWC Bridgeport! 

Please use the form below to donate online.  All online donations will include a 2.5% processing fee.  If you prefer, you may also send cash or a  check (made payable to "Fiat Ventures"), and give it directly to the teen.  (This way they are able to log their fundraising efforts). 

IMPORTANT: Please enter your name and mailing address as they would be typed on an envelope.  This will help us to send you a thank you letter with pictures from the teens service week as well as a tax deductible letter after the trip!

For questions, please contact Jean Stroud at jstroud@fiatventures.com.



Donation amount:


Donor's Information

*First Name
*Last Name
*Address
Apartment If Applicable
*City
*State
*Zip Code
*Email
*Home Phone (XXX-XXX-XXXX)
Cell Phone (XXX-XXX-XXXX)

Teen Participant's Information (only name and email required)

First Name
Last Name
Email
Home Phone (XXX-XXX-XXXX)
Cell Phone (XXX-XXX-XXXX)

Additional Information


Comments

Please enter any comments here.


Please hit button only once:

973.500.3300
P.O Box 4292, Warren, NJ 07059

Top