Mother’s Day Raffle Basket

Donation Amount:

$ 5.00

I'd like to help cover the transaction fees of 0 for my donation.

Mother's Day Raffle Basket must be picked up at AID Elgin (1135 Bowes Rd.) or AID Aurora (309 New Indian Trail Ct.)

In the event that your winning ticket is drawn, please indicate the best phone number to reach you:

Phone Number

Personal Info

First Name *

Last Name

Email Address *

Comment

Credit Card Info

This is a secure SSL encrypted payment.

Card Number *

CVC *

Cardholder Name *

Expiration *

Billing Details

Country *

Address 1 *

Address 2

City *

State *

Zip / Postal Code *

Donation Total: $5.00