Virtual Street Corner Collections Campaign! Posted on May 20, 2024May 20, 2024 by Moslahadmin Hospital Fund Drive Donation Amount $50 $100 $250 $500 Other Other Amount I would like to donate to (Please choose one)* Texas First Ladies’ 2024 Project Hospital Fund (In Honor or Memory of, please put in comments) Virtual Fall Hospital Fund Donor InformationName* First Last Email* PhoneCommentsPayment DetailsBilling Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name If you would like to cover all transaction fees so 100% of your donation goes to Shriners Hospitals for Children please check the box below I would like to donate an extra 3% to cover the service charge / fees. Additional Amount to Cover Service Charges Price: $0.00 Total $0.00 CAPTCHACommentsThis field is for validation purposes and should be left unchanged.
