The Lord's Diner Donation Form - Catholic Diocese of Wichita

Donation Information

Amount:

$ 50.00

$ 100.00

$ 250.00

$ 500.00

$ 1,000.00

$ 2,500.00

Other

$

*

Designation:

Additional Information

Type of gift:

One-time gift
Recurring gift

Frequency:

On:
Starting: Ending:

Corporate:

This donation is on behalf of a company

Anonymous:

I prefer to make this donation anonymously

What inspired you to give today?

Billing Information

Title:

First name:

*

Last name:

*

Country:

*

Address lines:

*

City:

*

State:

*

ZIP:

*

Phone:

Email:

*

Confirm Email:

*

Matching Gifts

My company will match my gift

Company:

*

Tribute Information (Optional)

Type:

*

Name:

*

First name:

Last name:

*

Mail a letter on my behalf

*

Diocese of Wichita Official Crest