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Please fill out the donation form below. You will receive a receipt via e-mail once your donation has been processed.

( * = required field )
First Name:  *  
Last Name:  *  
Organization:
Address:  *  
City:  *  
State:  *  
Zip Code:  *  
Country:
Phone:
Email:  *  

Please select if you would like to make a one-time donation or an automatic recurring donation:
Amount ($):  *  
$22.00   $22 Monthly Recurring  [ $22 Monthly will provide feed for 10 therapy horses. Please select Recurring option. ] 
$46.00   $46 Monthly Recurring  [ $46 Monthly Recurring helps a Veteran adjust to life after war. Select Recurring option. ] 
$72.00   $72 Monthly Recurring  [ $72 Monthly pays for the safety equipment that allows a child to ride. Please select Recurring op ] 
   [You may insert your donation amount here instead of using one of the above amounts.]
Payment Frequency:  *  
Start Date:  *   Calendar
No. of Donations:  *  

ADDITIONAL INFORMATION
Donation Type:   * 
Specify name below (Rider, In Honor Of, In Memory Of...) or Sponsorship Fees.
Donation Description:   * 
Please include address to send acknowledgements for donations made in Memory of and in Honor of.
Comments:

PAYMENT INFORMATION
Please select the credit card type:
Credit Card Type:  *  



Credit Card Number:  *  
(xxxxyyyyzzzzaaaa) no spaces or dashes
Expiration Date:  *     (mm/yy)
Card CVV Code:  *   3 or 4 digit code