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This form should be completed by those wishing to make a contribution to Burlington Day School via credit or debit card. Name and address should be entered as listed on your credit or debit card.
First Name
*
Last Name
*
Address
*
City
*
State
*
ZIP Code
*
Daytime Phone
*
Evening Phone
*
Email
*
Affiliation
*
Alumni
Grandparent
Friend
Current Parent
Parent of Alumni
Other:
Gift Type
*
Annual Fund Donation
Honorarium
Memorial
Payment Options
*
I would like to donate using my credit card.
Gift Amount
*
My gift will be matched by
Employer Name
May we list your name in published donor lists?
*
- select -
Yes
No
This gift is given in honor of
Please Note: Questions marked with an asterisk (
*
) are required.
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