Thank You for Your Gift!

Gift Information

Imagine a world where relationships are healthy, respectful... joyful.

All donations, small or large, make an incredible impact on the work we do day to day. Your gift helps strengthen our voice, working on behalf of victims and survivors across Virginia. With your help, we are better able to advocate for laws that support victims and hold offenders accountable. We are better able to provide crisis hotline services. We are better able to expand prevention initiatives that aim to stop offenders from creating victims in the first place.

Donation Amount*
  • $500
  • $250
  • $150
  • $75
  • $35
  • Other $
Donation Frequency*

Contact Information

First Name*
Middle Name
Last Name*
Postal Code*
Confirm Email*

If this gift is in honor or memory of someone, please fill out the following information:

Gift is in honor or memory of
Acknowledgment Address
Acknowledgment City
Acknowledgment State
Acknowledgment Zip Code

Payment Information

Card Type*
Name on Card*
Card Number*
Expiration Month*
Expiration Year*

Share This Form

Powered by eTapestry.