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 <select state here> Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 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.