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Welcome to the Independence House Virtual Fundraising Page

Our commitment for the health, well-being and safety of our Cape Cod Community keeps us from joining together in person at this time. In lieu of attending fundraisers that bring us together, we welcome your continued support with a virtual fundraiser donation. Your generosity allows us to continue serving members of our community who are impacted by domestic and sexual violence by providing free and confidential services for those who seek safety, justice, empowerment, and a life free from violence.

Thank you for your virtual fundraiser contribution

Create your own donation amount or choose from the options below:

Please input a positive dollar amount

$5.00$10.00$15.00$20.00$25.00$40.00$50.00$75.00$100.00$150.00$200.00$250.00$300.00$400.00$500.00$1,000.00$2,500.00$5,000.00$10,000.00

We welcome any additional instructions. If you would like to make this in honor or memory of, or would like to just include a note, please provide any details here:

Contact Information

Company:

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First Name:*

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Middle Name:

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Last Name:*

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Address:*

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Address2:

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City:*

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State:*

Province State is required for the United States

Postal Code:*

Please enter a value for Postal Code: Please enter a valid postal code.

Country / Location:*

Country is Required

At least one phone number is required.* Please enter at least one phone number

Mobile Phone:

Please enter a value for Mobile Phone: Please enter a valid phone number. Use x to denote extension

Home Phone:

Please enter a value for Home Phone: Please enter a valid phone number. Use x to denote extension

Email:*

Please enter a value for Email: Please enter a single valid Email.

Credit Card Information

Card Types Accepted:
Visa

Credit Card Number:*

Please provide a credit card numberPlease enter a valid accepted credit card number

Card Security Code:*

Please enter the security code. AMEX security code is a four digit code printed on the front side of the card above the number. MC, Visa, Discover is the last three digits printed on the back side of the card to the right of the signature. The security code is not stored, it is used for verificationPlease provide a security number

Expiration Date:*

/ ExprDate ExpirationYear Please enter the card Expiration Date. If the date is earlier than 05/2025, please elect to use another form of payment to complete this transaction.

Electronic Signature:*

I agree to pay above total amount according to card issuer agreement. Once the transaction has completed successfully, a confirmation receipt will be sent to the email address entered.

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Card Security Code

American Express Visa/MC/Discover
cvv

On American Express cards, the security code is four digits above your account number on the front of the card.

On Visa, MasterCard and Discover cards, the security code is the last three digits inside the signature strip on the back of the card.

The Security Code is not saved it is only used to request validation from the card issuer.

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Contact Us

For information about contributions to Independence House, Inc., please email Donna Giberti, Director of Development and Marketing at donnag@indhouse.net, or call 508-771-6507 x221.