Donation Information

Donation Amount*
  • $1000
  • $500
  • $250
  • $125
  • $50
  • Other $

Recognition Information

How would you like your gift to be recognized? (your name, your family, your group)

Name listing
Anonymous Listing
  • I prefer to make this donation anonymously.

Tribute Information

A TRIBUTE gift is in honor, in memory, or in celebration of a person or group.

 

Making an impact with Maine Adaptive is a wonderful way to say thank you, recognize, or remember. To make a tribute gift, please indicate what type below and include the name of the person and where notification should be sent. The amount of your donation will not be disclosed.

Tribute Name
Notify Tribute?
  • Yes

*If you have selected to notify your tribute, please use the fields below to provide additional contact information (email or mailing address).

Tribute Email Address
Tribute Mailing Address

Billing Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

Matching Gift Information

Please use the below fields to indicate if your employer matches gifts.

Company

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments

Security Code