Fields marked * require an entry.

Thank you for using this form to make a charitable donation
to Independence House, Inc.

If you would like to make a recurring monthly donation, we invite you to explore the

Independence House Lighthouse of Empowerment Giving Program

Donation Form

Donation Amount:

Please select where your donation is to be allocated:*

If you have additional information such as a name and contact information for a tribute donation you wish us to acknowledge, or a note about your donation, please provide the information here:

This is a joint gift from myself and:

This donation is in tribute to:

I would like to remain anonymous:

Yes

I would like to receive your newsletter:

Yes

Next
Reset