Offline Donation Form
Please use this form if you will be sending your donation via a mailed check, using stocks/securities, or directing from your Donor Advised Fund (DAF). Once you complete and submit this form you can simply mail your check to the Fund for processing (Gay & Lesbian Fund of Vermont - PO Box 42 - Randolph, VT 05060).

IMPORTANT - If you'd like to have a copy of this form simply print it out for your records before hitting the submit button at the end of the form!
Email address *
Your Name(s) *
Street Address/ Post Office Box *
This is where we will mail back your acknowledgement letter if requested.
City *
State *
Zip *
Phone Number *
In case we have questions about your donation.
Email Address *
In case we have questions about your donation or you want your acknowledgement to be sent via email.
Total Donation Being Sent to the Fund? *
This should be the total amount you are sending us.
Please list the recipient(s) of your donation. For each please include the name of the organization you are supporting and the amount they should receive. *
You can list as many organizations as you like below. You do not need to indicate an organization's address.
Would you also like to make a gift to the Gay & Lesbian Fund of Vermont? *
If indicated Yes on the previous question please enter the amount of your gift to the Fund below.
Should any of your gifts be anonymous? *
If only some of them should be anonymous please select "Other" below and let us know which donations should be sent as an anonymous gift.
How do you prefer to receive your acknowledgement once your donation is received and processed? *
Which method will you be using to send us your donation? *
Important Reminder!
Please be sure to print this page before hitting the submit button below if you'd like a copy for your records. Thank you.
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