HERS Donation Form

Support Our Cause

Help our organization by donating today! All donations go directly to making a difference for our cause.

How much would you like to donate? As a contributor to HERS we make sure your donation goes directly to supporting our cause.

$ Donation Amount:

I'd like to make this donation every

Who's giving today?

We’ll never share this information with anyone.

Personal Info

First Name *

Last Name *

Email Address *

Make this an anonymous donation.

Other Contact Information

Work Email

What is your preferred email?

Cell Phone

Street Address 1

Street Address 2

City

State

Zip Code

Country

Select HERS Fund

Please select the HERS fund to which you want your gift applied:

Select Fund

Yes No

Currently enrolled HERS alum Neither

Cohort year:

Summer Online Weekend Not sure

Bridgewater, MA Bryn Mawr, PA Wellesley, MA Denver, CO Golden, CO Philadelphia, PA Virtual

Virtual

Newton, MA Warrenton, VA Wellesley, MA

Is your gift in tribute to someone or in memory of someone?

Yes, please
No, thank you

Dedication Type

Honor
Memorial

Honoree Details

First Name *

Last Name *

Would you like us to notify anyone of your donation?

Yes, mail a card
No thanks

Notification Details

Personalized Message * 255 Characters left

First Name *

Last Name *

Country *

Address Line 1 *

Address Line 2

City *

State *

Zip/Postal Code *

Select Payment Method

Donate with Pay by Credit Card
Donate with Mail a Check

Credit Card Info

This is a secure SSL encrypted payment.

Card Number *

CVC *

Cardholder Name *

Expiration *

Here's what you're about to donate:

Donation Summary
Payment Amount
Giving Frequency Consider making this donation	One time
Donation Total

Donation Total: $25.00 One Time