Notification Form for Online Donations

Fill out the form below with instructions as to how notification should be given regarding your gift. Upon receipt of your donation, Stewpot will send a card immediately notifying your designee(s) of your gift in their honor.

I have made on online donation thru PayPal. Please notify the designee as follows:
Name
 
Street Address
 
City/State/Zip
 
State
 
Amount of Gift
 
Phone Number
 
Email  
Designee's Name/In memory of or In honor of:  
Mailing Address  
City/State/Zip