HAVI Donation Form - Pay By Check

We are deeply grateful for your decision to support our work. Please complete the form so we can know to expect your check. Once completed, instructions will be emailed to the address you provide.

Name

First Name

Last Name

Organization

Donation Amount

Donation Assignment

This is for internal accounting purposes and not subject to change.

Name/Business That Will Appear on Check

Special Note

You can share any additional information here