Form

Donations to the Leaders’ Fund

Thank you for your generous support of SHAFR.

Donation Amount *

USD Donation

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

We accept Visa, MasterCard, American Express, JCB, and Discover cards.
Payments are processed by Stripe.

SHAFR is a 501(c)3 not-for-profit professional society.
A receipt of each gift to this fund will be provided for tax purposes.
Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail *
May we publish your name on a list of donors in Passport?

Yes
(Optional) Special comments or directions
Should be Empty: