Skip to content

Search for:

Internal Donation Form

$ Donation Amount:

Make this donation monthly

Select Payment Method

Credit Card

Personal Info

First Name *

Last Name *

Is this donation on behalf of a company?

No
Yes

Company Name

Phone

Email Address *

Comment

Has Spouse

Has Spouse

I'd like to make this donation with my spouse or partner.

Spouse/Partner Info

Prefix

First Name

Last Name

Phone

Email

Dedicate this Donation

Yes, please
No, thank you

Dedication Type

In honor of
In memory of

Honoree Details

First Name *

Last Name *

Would you like us to notify anyone of your donation?

Yes, mail a card
Yes, send an eCard
No thanks

Notification Details

Personalized Message * 255 Characters left

First Name *

Last Name

Email Address *

Notification Details

Personalized Message * 255 Characters left

First Name *

Last Name

Country *

Address Line 1 *

Address Line 2

City *

State *

Zip/Postal Code *

Credit Card Info

This is a secure SSL encrypted payment.

Card Number *

CVC *

Cardholder Name *

Expiration *

Billing Details

Country *

Address 1 *

Address 2

City *

State *

Zip / Postal Code *

Donation Total: $35.00 One Time

{amount} donation plus {fee_amount} to help cover fees.

The Los Angeles LGBT Center is a 501(c)(3) tax-exempt organization. Your gift is tax-deductible to the fullest extent allowed by law. As a supporter, you'll receive email updates from the Center. You can unsubscribe at any time.

If you have any issues, please contact [email protected]

Terms of Service | Privacy Policy | California Privacy Rights
© Copyright Los Angeles LGBT Center