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RFS Secure Online Donation Form

 


 

Your tax deductible donation to Rockland Family Shelter will have a positive impact on the women and children who are survivors of domestic violence and sexual trauma by helping to provide them with emergency shelter, a 24-hour hotline, and a myriad of critical programs and services. You will be saving lives and giving a future of hope to many.

Instructions:

Please complete the form below. All fields, except the special comments section, are required. When you press the submit button you will be brought to a secure server to enter your credit card information. After the donation process is complete you will receive an e-mail confirmation and you will receive an ackowledgement for tax purposes. If you would like to make a donation in memory or in celebration of someone special, please enter these details in the special comments section. If you supply us with the address in the special comments section we will also send a personalized card to the person you are honoring (or the recipient's family). Thank you so much for your support.

Rockland Family Shelter Secure Online Donation Form
Donation Amount
  Please enter the amount you wish to donate without the dollar sign. Example: 22.00
Full Name
Address
City
State
Zip Code
Telephone
E-Mail
Special Comments
  Use the text box above to enter any special comments or the name and address of the person you would like to make a donation in honor or celebration of.