Online Donation

First Name*

Last Name*

Organization

Address*

City*

Zip*

State*

Phone*

Email*

I would like my gift to support:

Donation type

Onetime Recurring

Frequency

Monthly

Number occurrences

Amount

$ 10.00 $ 25.00 $ 50.00 $ 100.00 $ 250.00 $ 500.00

Payment method *

Credit Card
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Card type*

Card Holder Name*

Credit or Debit card*

Verification code*

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“I cannot thank you enough for the screening you did at my daughter's preschool last October. I am exponentially grateful that we already know her eyes need extra help to make reading possible. Thank you, thank you, THANK YOU!"

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