Upper Valley MEND

Together we work to build an empowered community with equitable access to food, housing, healthcare and emergency services.

Your support makes it possible. Thank you!

Your donation:

Donation Amount

Area of Greatest Need

Community Cupboard Food Bank

Affordable Home Ownership - SHARE Community Land Trust

Upper Valley Free Clinic

Community Harvest Produce Gleaning Program

Cornerstone Community Adult Family Home

Emergency Financial Assistance

Recurring Option

Billing and Contact Information

First Name: *

Middle Initial:

Last Name: *

Email: *

Country: *

Address: *

City: *

State: *

Province:

Zip/PostalCode: *

Phone:*

Full Name

Additional Questions

I would like my name to remain anonymous.

Yes

Donation made in memory/honor of:

Anything else we should know about your gift?

Would like to receive emails about the good your gift is doing?

YesNo

Honor/Memorial Gifts

I want to dedicate my donation to someone:

In Honor Of In Memory Of Tribute To

In Memory Of:

Honoree Name:

Send Email acknowledgement to:

Send Postal Mail acknowledgement:

First Name:

Last Name:

Address Line 1:

Address Line 2:

City:

State:

Zip/Postal Code:

Country:

Dedication Message:

Payment Details

Credit Card eCheck

Routing Number: *

Account Number: *

Check Number: *

Account Type: *

Check Type: *

Name on Card: *

Credit Card Number: *

Card Verification (CVV): *

Expiration Date: *

CardExpirationYear

Invoice Number:

Purchase Order Number:

Name: *

Reference Number:

Your donation:

Honor/Memorial Gifts

You will be charged:

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