Association for Death Education and Counseling

Donations - Secure Online Donation Form

Campaign/Fund Information
Campaign/Fund *	General Fund or Select a Different Fund

Donation Information
Donation Amount *	$
Payment Method *	Credit Card
Donation Type *	One-Time Donation Recurring Monthly Donation (until cancelled)
In Memory Of	Give in memory of a person important to you, who has died. We join you in cherishing this person's gifts and ongoing inspiration in your life. Freely tell us more in the optional "Donor Comments" entry below.
In Honor Of	Give in honor of someone living. Freely tell us more in the optional "Donor Comments" entry below.
Welcomed Me to ADEC	Give to ADEC's future by thanking a member who welcomed you into ADEC. Tell us more in the optional "Donor Comments" below. Suggested donation of $10.
May we share your name on our Donor List (i.e., webpage, Annual Report, newsletter? *	Click on this dropbox and select "Yes" or "No." Freely add more notes in the "Donor Comments" below.
Likewise, may we share the name of the person you are honoring? (In Memory, In Honor, Welcomed Me) *	Click on this dropbox and select "Yes," or "No," or "Not Applicable." Freely add more notes in the "Donor Comments" below.
Donor Comments

Donor Information

First Name *
Middle Name
Last Name *
Suffix
Organization
Email *
Address *
Address Cont.
City/Town *
Country *
State/Territory	(Reset)
Postal Code*
Phone *

Billing Information
[ Click here if billing address is the same as donor address ]
Name on Card *
Card Type *
Card Number *
Card CVV Num *	What is this?
Exp. Date *	/
Organization
Address *
Address Cont.
City/Town *
Country *
State/Territory	(Reset)
Postal Code*
Billing Phone *

The Cardholder stated above has authorized this payment. If this payment is part of a recurring series of payments, the Cardholder understands the terms and amounts of those recurring payments, and authorizes payment for each of them. Cardholder consent will expire once all scheduled recurring payments have been processed, or if all future recurrences are cancelled. The Cardholder acknowledges that specific payment dates may vary. Examples include, but are not limited to: payment dates falling during weekends, holidays, or during system outages. In order to facilitate the processing of those recurring payments, stored credentials will be used. Those stored credentials will only be used to process payments that are part of this series of recurrences. In order to use those stored credentials for any other payment, Cardholder re-authorization will be required. In the event that a consent agreement must be modified, the new agreement will be sent to the email address associated with the invoice.

The Cardholder understands the terms and authorizes the payment(s).

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Association for Death Education and Counseling