Donate Recurring

Donate to Children’s Health Defense

This form is only for a monthly recurring donation. You can also make a one-time donation and/or become a member.

Please don’t hesitate contact us if you need assistance with donation or have any questions.

We are a 501(c)(3) non-profit organization. Donations (including your membership fee) are tax deductible to the full extent of the law. Our EIN is 86-3103020.

Name*
First Last
Email*
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Credit Card
Card Details
Cardholder Name
Are you a CHD member?*
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Membership Options*
Membership Fee
Price:
Donation Amount
Please enter your recurring amount which will be charged to your credit card on a monthly basis. If you're becoming a member, the $10 fee will only be charged once.
Total
$0.00
Where are you located?*
US Phone
SMS - Text Messages
I agree to receive text messages from CHD. Msg/data rates may apply. You can opt out at any time.
Int'l Phone
SMS - Text Messages
I agree to receive text messages from CHD. Msg/data rates may apply. You can opt out at any time.
Address*
Street Address City State ZIP Code
Address*
Street Address City State / Province / Region ZIP / Postal Code Land
Optional: Demographic Information
To determine how you may be able to help in our legal efforts and initiatives, we are requesting demographic information about you and your family.
Your Age
Do you have any children in these age groups?
You can select multiple fields.
What is your occupation?
Would you like to become a CHD volunteer?
In what areas would you like to volunteer?*
You can select multiple fields.
Please tell us about any special talents that you could provide as a volunteer?
E-Mail
This field is for validation purposes and should be left unchanged.

Our promise to you:
Your personal information will only be used by Children's Health Defense and its Arizona Chapter.

Thank you so much for supporting Children's Health Defense - Arizona Chapter!