Discussion Forum
A place for registered ACHA members to discuss issues with other members of the ACHA community and provide and receive support.
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Tribute Donation Form

Do you want to make your donation by check? Please send your donation payable to ACHA to 6757 Greene Street, Suite 335, Philadelphia, PA 19119.









(**Make a gift of $1,000 and become a member of our President’s Circle.)

If this is a recurring gift, what is the frequency? (example: weekly, monthly, quarterly, annually)

Dedication


FUNDS


If you would like to donate to a specific memorial fund, please check the box below. More information on each fund can be accessed under the "Donate" tab to the left.

NOTIFICATION


Please send notification of this gift to:



Additional Instructions


If needed, please provide ACHA with additional instructions regarding your gift in the box below. For example:

  • This gift is in honor of John Smith and Mary Jones. Please send two separate notification letters.
  • Please separate my $50 donation among the following funds: $25 in memory of Jane Brown and $25 for the Heart Heroes Scholarship Fund.

PRIVACY STATEMENT


The Adult Congenital Heart Association takes the confidentiality of your information very seriously. For this reason, we use the highest level of security technology provided when dealing with your credit card information. To guard against fraud, your information is securely encrypted and automatically passed directly to the financial network for processing. At no time is this information made available to any other party.

Billing Information






















PAYMENT INFORMATION






   


The credit card verification code is a 3 or 4 digit number, normally located on the back of your card.



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