The University of Arizona

Donation Have an account? Click here to log in...

BY COMPLETING THIS FORM YOU ARE MAKING A DONATION ONLY

Making a donation does NOT register you for the Melanoma Walk.

To REGISTER, you must complete the registration form and submit your registration fee.  

If you would like to register AND make a donation, you may do both HERE.

THANK YOU!

* Donation Amount:
This is a one time donation
Make this a recurring donation deducted
Prefix:
* First Name:
* Last Name:
Suffix:
Title:
Department:
Company:
* Address:
* City:
* State:
Province (Foreign)
* Zip Code: -
* Email:
* Phone:

Gifts in support of the Melanoma Walk are administered through the University of Aizona Foundation, a 501(c)(3) charitable organization.  Your gift is tax-deductible to the full extent provided by law.

Comment:

If you would like to manage your account (i.e., view donation history, change address, etc.), please create a login name and password.
Create a Login Name:
Login Password:
Retype Password:
Credit this donation to this Social Fundraiser:

Billing Information
* Credit Card Type:
* Credit Card Number:
* Card Expiration:
* Credit Card CVV2:
* Cardholder First Name:
* Cardholder Last Name:
* Billing Address:
* City:
* State:
* Zip Code: -
    
NOTE: Please only click the 'Submit' button once. Your payment may take time to process.

Powered by NeonCRM