Individual Donation

My Contact Information

BA ID (if applicable): Prefix: First Name: Last Name: Email: Phone: Address: City: State: Zip: - Province (Foreign): Country:

My Gift

Suggested Donation Amounts:

$1,000

$500

$250

$100

$50

$10

Other Amount

$1,000

$500

$250

$100

$50

$10

Other Amount

Keep Anonymous:

This is a one time donation.

Make this a recurring donation deducted.

BA Only: Please add an additional monthly donation to my SmartShip order in the amount of: BA Only: Please allocate a percentage of my commission to ECHO Connection in amount of:

Designate My Gift

Tribute Type: Tribute Name: Comment:

Notify the Following of My Gift

We will send a notice of your contribution and/or comment without disclosing the amount.

Acknowledge To: Email:

ECHO Connection is a 501(c)(3) non-profit organization, U.S. Federal Tax ID 81-4542024; therefore your contribution is tax-deductible to the extent allowed by U.S. law.

Billing Information

Payment method: Credit Card
American Express

Cardholder First Name: Cardholder Last Name: Credit Card Number: Card Expiration: Credit Card CVV2:

Zip Code: - Credit Card Type:

NOTE: Please only click the 'SUBMIT' button once. Your payment may take time to process.