Please enter the amount you wish to donate to each designation:

The Hoosac Fund (Annual Giving):

Capital Improvements:

Hoosac! A Brighter Tomorrow! (Sponsor A Solar Panel)

The Rev. Meredith B. Wood Foundation:

_______________________________________

TOTAL GIFT AMOUNT CALCULATION:

Notes regarding gift:

Title*

Full Name*

Home Address*

City*

State*

Region

Country*

Zip*

Telephone*

Email Address*

Please have a Hoosac representative contact me regarding my gift:

Yes

Payment Options

I will be paying a charge of $ for months for an overall total of $ for years for an overall total of $ times for an overall total of $ times for an overall total of $ beginning with a charge today of $

Remaining payments will take place between and with the next payment occurring on

You can cancel your subscription by emailing info@hoosac.org or calling 518 686 7331

Please send a confirmation email to the address below*:

Please provide an email address where we can send a link to your current form.

Email Address :