Donate - ShareHouse

Donation Amount

$20
$30
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Amount to Donate

( Please enter your donation amount in the format of 'x.xx' )

How often would you like to give this donation?

(If you would like your gift to be recurring please select how often below)

Total Donating

$0.00

First Name*

Last Name*

Billing Address Line 1*

Billing Address Line 2

City*

State*

Zip Code*

Email Address*

Select a Fund*

ShareHouse General Fund – Gifts to be used where the need is greatest.
Helping Hand Fund – Funds to pay for situations that are barriers to recovery and when the Patient has no other option for funding, i.e. Clothing for new job, medical co-pays, transportation, etc.
Sober Fun Fund – Gifts to fund sober fund activities and supplies.

Credit Card

American Express

Discover

MasterCard

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Card Number Expiration Date Security Code Cardholder Name

My gift is in memory or honor of someone or for an occasion of:

Yes

In memory of:

In honor of:

For occasion of:

Send acknowledgement to:

Name

First Last

Address

Street Address City State ZIP Code

Please contact me about including ShareHouse in my estate plans.

Yes

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How can we help you?

Daytime Phone

or After Hours

Talk to a Counselor

WalkIn Clinic Hours