Alzheimer's Foundation of America

Donation is Simple:
- Choose Amount
- Info
- Payment
- I prefer to make my gift anonymously
Donor Information*
- Individual
- Corporate/Organization
Company/Organization Name
Title
Name*
First Middle Last
Point of Contact
(Company point of contact if different from donor name)
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Donor Email*
Please select a donation type*
- General Donation
- In memory
- In honor
Notification Type*
- Send by Letter
- Send by E-mail
Special Father's Day E-Card
If this gift is for Father's Day, click here if you would like a special email sent to notify someone of your gift.
- Special Father's Day E-Card
Tribute Name*
The person whose name you would like to make the gift in.
First Name Last Name
Please send Tribute card/E-mail to:*
The person who you would like to be notified of this gift.
First Name Last Name
Notification Email*
Email address of the person you would like notified of this gift.
Notification Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Donation is Simple:
- Choose Amount
- Info
- Payment
Billing Information
Billing Address must be the same as your credit card's billing address*
Same as Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Payment Information*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Full Name (as it appears on the card)
Matching Gifts
- My company will match my gift
Programs and Services
- Apply my donation to support AFA's Programs and services
Please apply my donation to:
- Programs and services
- Research
- Wherever the need is greatest
Research
- Apply my donation to support research.
Temporarily Restricted
Total
$0.00
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