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 PORT MERCY   1019 North First Avenue, Lake Charles, LA  70601  PH: (337) 433-5022 E-mail: info@friendships.org

Online Donation Form

 

By Credit/Debit Card (please enter a debit card as a credit card) or Checking Account/Echeck (please provide your Bank Name, Drivers License, issuing state, and D.O.B. information for your Echeck to process).

Thank you for choosing to make a difference by making a donation.  Donations like yours enable us to do so much more to help alleviate the pain and suffering of those around the world.

Four steps are required to complete an online donation. 

Donations can also be made by phone, or by printing this form and mailing it to us. 

Step 1:

 Contact Information (* required fields):

Very important, please make sure that your contact information matches the billing information listed at your bank.

*First Name

*Last Name

Organization

*Address

Address 2

*City

*State

*Zip/Postal Code

*Country

Province/State

(Outside the USA)

(Outside the USA)

*Telephone

Example: 337-433-5022

*E-mail

 

 

~Please contact us for any Credit/Debit Card donation greater than $2,500.00 or a ECheck donation greater than $200.00.~

  

*Note for Echecks on Step 4 Please provide your Bank Name, Drivers License, issuing state, and D.O.B. information for your Echeck to process.  Thank You.*

Step 2:

Please designate your contribution by checking one of the following boxes:

General Financial Donation (To be used where needed most)

Current Mission

Israel Mission

Disaster Response

Medical Outreach
 Friend Ships International - Roatán
Specify (Example: Haiti Rice, Haiti Beans):

Donation Amount: $

Listed amount in U.S. Dollars.

Frequency: (You must Fill out Step 3)

 

Comments:

 

~Please contact us for any Credit/Debit Card donation greater than $2,500.00 or a ECheck donation greater than $200.00.~  

*Note for Echecks on Step 4 Please provide your Bank Name, Drivers License, issuing state, and D.O.B. information for your Echeck to process.  Thank You.*

Thank you so much for your donation. You will automatically receive our next monthly Activities Report by email (unless you specify in the above comments to mail it). If you have previously asked not to be on the mailing list, we will not be adding your name.

This will inform you of our current and upcoming activities. If you have a SPAM filter please allow the activities@friendships.org to be accepted.  If you do not wish to receive the report we will be happy to remove your name promptly.  Please notify us.

*Note: Any personal information received through Friend Ships is never sold or given out to any other organization or company*

Please contact me with further information about Volunteering:
 Day Worker - Local Lake Charles residents only
 Guest Volunteer (short term, up to 2 months service)

Volunteer Staff Member (long term, over 2 months service)
 

  

Step 3:

Make an automatic donation (leave blank if you selected one-time donation):

        month(s) (up to 3 years)         

-or-   Every days (Min 7, Max 365)

              Start Date

* (Mm/Dd/YYyy)  Fill out

         End Date

* (Mm/Dd/YYyy)  Fill out

-or-   Ends After

occurrences

 

 

~Please contact us for any Credit/Debit Card donation greater than $2,500.00 or a ECheck donation greater than $200.00.~

  

*Note for Echecks on Step 4 Please provide your Bank Name, Drivers License, issuing state, and D.O.B. information for your Echeck to process.  Thank You.*

  

    

NOTE:

IF you choose (automatic) donation method, it is your responsibility to inform us if you want to change or cancel at least two weeks before the next specified day to be charged.

    

Step 4:

Click the continue button to be enter our secure site to proceed with your online donation.  By continuing you will then enter your Credit/Debit Card (please enter a debit card as a credit card) or Checking Account/E-check (please provide your Bank Name, Drivers License, issuing state, and D.O.B. information for your E-check to process).  Very important, please make sure that your contact information matches the billing information listed at your bank.

Online Payments

 

Thank You For Your Donation!

Form updated August 2007