Annual Campaign Giving Form

Our Annual Campaign, conducted in large part by a group of dedicated volunteer fundraisers, provides program funds and operating capital that directly impacts the lives of children and adults with disabilities in Wisconsin. Your support – and that of all of our volunteers and donors – is deeply appreciated. Thank you!






$
Annual Campaign
  (clear)
 
 
(Example: ABC Packaging Company or John & Mary Brown, etc. )

Increase the Size of Your Gift!

Many companies offer employees a matching gift benefit that can double or even triple your gift.  A partial list of companies with a Matching Gift Program can be found HERE. Matching gift forms can be obtained from your employer, completed and sent to:

Easter Seals Wisconsin
101 Nob Hill Rd., Suite 301
Madison, WI 53713

Credit Card Information
Enter numbers only, no spaces or dashes.
Security Code Location on Credit Card
Usually the last 3-4 digits in the signature area on the back of the card.
 
Billing Name and Address
Enter the name as shown on your credit or debit card, and the billing address for this card.
Facebook logo

Theme by Danetsoft and Danang Probo Sayekti inspired by Maksimer