Donate : Contact : Live Healthy Appalachia

Help us empower Appalachian communities to lead healthy lives.

Name(s) as it will appear on donor acknowledgment (Required)

Email (Required)

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Donation Amount

If "Other" please use "Other Amount" field.

Other Amount

Cardholder Name (Required)

Credit Card # (Required)

Visa MasterCard American Express Discover

Expiration Date (Required)

Security Code (Required)

Visa®, MasterCard® & Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.

Billing Zip Code (Required)

Make this a monthly payment?

Yes, bill my card today and on the 30th of every following month. (if the month doesn't have 30 days, your card will be billed on the last day of the month.)

Make this a monthly payment?

Your total payment will be

Your credit balance will cover

Your credit card will be charged

Your bank account will be charged

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