Contact Us

Use the form on the right to contact us.

You can edit the text in this area, and change where the contact form on the right submits to, by entering edit mode using the modes on the bottom right.

123 Street Avenue, City Town, 99999

(123) 555-6789

email@address.com

You can set your address, phone number, email and site description in the settings tab.
Link to read me page with more information.

Donation For Individuals

First Name: Last Name:

One-Time Gift

Recurring Gift to be Given

I would like to make a donation in the amount of:

$25 Recurring Donation

$50 Recurring Donation

$100 Recurring Donation

$150 Recurring Donation

$200 Recurring Donation

$250 Recurring Donation

$300 Recurring Donation

Other Donation Amount:

$25 One-Time Donation

$50 One-Time Donation

$100 One-Time Donation

$150 One-Time Donation

$200 One -Time Donation

$250 One-Time Donation

$300 One-Time Donation

Other Donation Amount:

Address: Address Line 2: City: State: Zip Code: - Email: Phone: If this is your first time to donate, please tell us how you heard about The Refuge:

* Required Fields

OPTIONAL: In Honor Of Or In Memory Of Section

If this donation is In Honor or In Memory of someone or for a special occasion, please let us know below:

Please choose: In Honor / In Memory Name:

If you would like The Refuge to send an Acknowledgement Card on your behalf, please provide the following information:

Send Acknowledgement Card to: Acknowledgement Address: City: State: Zip Code: - Acknowledgement Email:

Billing Information

Payment method: Credit Card
American Express

E-Check Pay Later

Card:

Cardholder First Name: Cardholder Last Name: Zip Code: -

NOTE: Please only click the 'SUBMIT' button once. Your payment may take time to process.

E-Check Billing Information

NOTE: Please only click the 'SUBMIT' button once. Your payment may take time to process.

Check the box below if you prefer to send payment by mail.

Payments can be mailed to: The Refuge for DMST

P O Box 90804

Austin, TX 78709-0804

I will mail in a check

NOTE: Please only click the 'SUBMIT' button once. Your payment may take time to process.

Neon CRM by Neon One