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New One Time Donation

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Email (optional)

Password (optional)

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Business Name Organization Name

Contact Name

Is this organization a tax exempt 501c3?

EIN (Federal Tax ID Number)

First Name

Middle Initial

Last Name

Address

Apt #

City

State

Zip

Email Receipt To:

Contact Phone

This information will only be used to contact you with any questions related to your donation and will not be shared.

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Payment Type

ALL checks MUST be mailed to the following address:

OAIS SGO
PO Box 492
Granville, OH 43023

Please confirm check date is for 2023 and made payable to OAIS SGO

Card Number

Expiration Date

Security Code

Yes, please cover the cost of my donation by adding 3.5% to cover processing fees. Note that while fees are tax deductible, only the total of your donation is eligible for a tax credit.

									Credit Card Fee

									$0.00

PayPal payment processed

Account Type

Bank Name

Routing Number

Account Number

Description of Securities

Additional Notes or Comments? (optional)