Make a Donation

Please use this form to make a donation to the Utah Afterschool Network.

After you have selected your donation amount and completed the required information, you will be directed to PayPal to complete this transaction with a credit card or existing PayPal account (note: you do not need a PayPal account).

( * = required field )

First Name: *

Last Name: *

Organization:

Address: *

Address 2:

City: *

State: *

Zip Code: *

Phone: *

Email: *

Confirm Email: *

Please select if you would like to make a one-time donation or an automatic recurring donation:

One-Time

Recurring

Amount: *

$500.00	$500
$250.00	$250
$100.00	$100
$50.00	$50
$25.00	$25
		[You may insert your donation amount here instead of using one of the above amounts.]

Payment Frequency: *

Start Date: *

No. of Donations: *

ADDITIONAL INFORMATION

Would you like to be added to our email list?: *

Yes, please add me. No, thank you.

Messages:

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