Donation in honor of...
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Email address
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DONATION INFO
Date of Donation:
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MM
/
DD
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YYYY
From: (your name/organization)
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Your answer
Amount:
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In honor of: (name)
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Special Note: (optional)
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DELIVERY OPTIONS
How would you like your Certificate delivered?
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Emailed to me (at the email provided above)
Emailed to the honoree (please add their email below)
Mailed to (please add address below)
No certificate needed
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Email to: (name & email)
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Mail to: (name & mailing address)
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List honoree on HugsthatEmpower.org?
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MAKE YOUR DONATION (if you have not already)
If you have not already made your donation, please do so here below or at
www.HugsthatEmpower.org
. Thank you for your support!
A copy of your responses will be emailed to the address you provided.
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