Healthy Giving Club - The Fit and Food Connection

To donate, please fill out the following form and click the "Submit" button. You will then be redirected to Paypal's website (www.PayPal.com) to finalize your payment.

How much would you like to donate?
Donation amount*
I would like to make a donation in the amount of:
- $5 / month
- $10 / month
- $25 / month
- $50 / month
- $100 / month
- Other
Other amount
Please enter a value greater than or equal to 0.
Your total donation amount*
Price: $0.00
Donation details
Please enter your name*
First name Last name
How did you hear about us?
Why are you donating?
Email*
Phone
- I would like to remain anonymous
- Add me to your mailing list
Donor address
Please enter your address details*
Street Address Address Line 2 City State ZIP Code
Donor message
Total donation amount
Total
$0.00
Phone
This field is for validation purposes and should be left unchanged.

How much would you like to donate?

Donation details

Donor address

Total donation amount

Thanks to some of our donors for helping us create smiles and healthy clients!