Mille Lacs Area Health Foundation Donations

Donor Info
As It Appears On Donator's Credit Card or Checking Account.
Address Where Your Credit Card or Bank Statements Are Mailed.
Please Include Your City, State and Five Digit Zip Code.
Your Donation Info
$
Please Specify How Much You Are Donating. Please Use Dollars and Cents.
Input The 16 Digit Number Just As It Appears On Card.
Example: 00/00
on back of credit card next to signature line