Test

Share this content:

Donate - Old

"*" indicates required fields

Donor Information

Name*

Hidden

Address

Street Address City State ZIP Code

Phone

Email*

Purpose of Donation*

Please state here if you would like to earmark this donation for a specific purpose.

LymeAid 4 Kids Fund

General Donations

Dedication Information

Click here In of / In Memory of

Click here in Honor of / In Memory of

Acknowledgement Information:

Dedication Type

In Honor Of

In Memory Of

Name of Person/Family to be Honored/Memoralized*

Name of Person/Family Making Donation

Personal Note - In Memory Of

(Example) Dear Mary, Our deepest condolences on the loss of your mother. Sincerely, Jack & Jane Smith 100 Mockingbird Lane New Jersey, NJ 12345

Personal Note - In Honor Of

(Example) Dear Mom, Happy Mothers Day! Thank you for being so amazing and supportive through our struggles with Lyme disease. love, Jane, Jack and Jill

Name of Person/Family to be Notified*

Notification Method*

Select All

Postal Mail*

NOTE: Due to US Post office problems, mail deliveries are often delayed. It's beyond the control of LDA.

Email of Person/Family to Receive Notification Letter*

Email for Donor to Receive CC of Notification Letter

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Hidden

Please send an honorary donation notice to the following person(s):

Hidden

I would like a notice sent to the honoree at the following email address:

Hidden

I (we) wish to have our gift remain anonymous.

Hidden

Signature

Hidden

Date

Price*

Total

Credit Card

Additional Resources

Lyme Disease

Babesiosis

Anaplasmosis

Heartland Virus

Colorado Tick Fever

Borrelia miyamotoi

Ehrlichiosis

Powassan Virus

Rickettsia

Rocky Mountain Spotted Fever

Tularemia

Tick Borne Relapsing Fever

STARI

Pacific Coast Tick Fever

Bourbon Virus

Bartonella

Q-Fever

Tick Paralysis

Prevention!

Test

Donate - Old

Donor Information

Dedication Information

Acknowledgement Information: