Invoice for Orchid Giving Circle
Donation Levels
$ 5,000.00
$ 2,500.00
$ 1,000.00
$ 500.00
Other amount
$
*
Additional Information
Frequency:
Weekly
Monthly
Quarterly
Annually
On:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Starting:
Ending:
Ending:
To Invoice Your Company Please check the box below
Invoice My Company
If invoice contact information is different than the person filling out the form, please indicate here
Name of Giving Circle Contact:
*
Billing Information
Title:
Dr.
Mr.
Mrs.
Ms.
First name:
*
Last name:
*
Country:
United States
Canada
*
Address lines:
*
City:
*
State:
<Please Select>
AA
AE
AL
AK
AB
AS
AP
AZ
AR
BC
CA
CZ
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MB
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NB
NH
NJ
NM
NY
NL
NC
ND
MP
NT
NS
NU
OH
OK
ON
OR
PW
PA
PE
PR
QC
RI
SK
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
YT
NSW
Mah
*
ZIP:
*
Phone:
*
Email Invoice to:
*