Clone of UnGala Donation Form

We would be delighted to (NOT) attend, but want to support Hands of Peace! *

$100 sponsors snacks or equipment for our summer program $250 contributes to the creation of our 2 minute videos $500 sponsors an activity in the Middle East $1,000 sponsors a leadership event for American alumni $2,000 sponsors a dialogue facilitator $3,500 sponsors a Hands of Peace participant from the Middle East

Total Calculation

Donation amount *

USD

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail *

Phone Number *

Area Code Phone Number

Please indicate the purpose of this donation: *

Chicago Program San Diego Program

Is this a donation in honor of or in memory of someone? *

Yes, in honor of Yes, in memory of No

Please enter the honoree's name and address, so that we can send a thank you note:

Honoree's name:

First Name Last Name

Honoree's address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Please indicate the name of the deceased and the name and address of a surviving family member, so that we can send a thank you note:

Name of deceased:

First Name Last Name

Name of recipient:

First Name Last Name

Recipient's address:

Street Address

Street Address Line 2

City State

Zip Code Country

Would you like to make this a recurring donation? *

Yes, I would like to donate annually Yes, I would like to donate monthly No

How did you hear about Hands of Peace? *