One Time Credit Card Donation Form

If you prefer, you can print this page, complete the form, and mail it to us. If you choose

this option, you must sign your name where indicated below. Please mail the completed

and signed form to:

Feed Washington

8435 161st Ave. NE

Redmond, WA 98052

To process your donation on-line, please provide the information requested below:

Required Information **

Name**

Organization

Street Address (Your credit card billing address)**

City** State** Zip**

Phone**

**Your phone number will never be given to anyone for any reason. We require

it only so we can contact you if there is a problem in the processing of your donation.

Email Address**

Amount of Your

Donation** Will your employer match your donation?

$ (No Minimum)

Type of Card**

Credit Card Number** Expiration Date**

Please sign here if mailing us this form:

___________________________________

We would love to recognize your generosity by adding your name to the

donor list published on our website. If you would like to be recognized on

our Corporate Donor list, please include your corporation's name above.

Yes, please include my name on the donor list.

No, I would prefer not to be recognized.

How did you hear about us? Comments?