Donate: New Website Test Form Your Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Email* Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code My donation is for...*Membership (New or Renewal)General Support of Foundation's MissionBrickEducational Experiences EndowmentSpecific Program/ProjectTribute Gift - In Memory/In Honor OfMonthly or One-time Gift?*MonthlyOne-timeOne-time Gift for Membership*Bird Watcher ($60)Fossil Friend ($125)Trail Explorer ($250)Conservation Champion ($500)River Guardian ($1,000)Monthly Gift for Membership*Bird Watcher ($5)Fossil Friend ($10)Trail Explorer ($21)Conservation Champion ($42)River Guardian ($85)One-time Donation Amount* Monthly Donation Amount* Donation Amount* Do you want the Indiana State Park Pass that is included with your membership level?We are required to purchase your State Park Pass from the Indiana Department of Natural Resources. Please let us know if you'd like to help offset the cost of your Indiana State Park Pass and increase the impact of your gift! Or, you can keep your donation amount the same.Yes, I want my State Park Pass and will offset its cost with an additional $50.00 to help the Foundation.Yes, I want my State Park Pass but I'd prefer to keep my gift amount the same.No, I don't need the Park Pass and would rather the Foundation use the extra towards your mission.Do you want the Indiana State Park Pass that is included with your membership level?We are required to purchase your State Park Pass from the Indiana Department of Natural Resources. Please let us know if you'd like to help offset the cost of your Indiana State Park Pass and increase the impact of your gift! Or, you can keep your donation amount the same.Yes, I want my State Park Pass and will offset its cost with an additional $5.00 per month to help the Foundation.Yes, I want my State Park Pass but I'd prefer to keep my gift amount the same.No, I don't need the Park Pass and would rather the Foundation use the extra towards your mission.Do You Qualify for a Golden Hoosier Park Pass?Yes, I am 65 or older.No, I do not qualify.Donation Designation and Tribute GiftsPlease use the form below to tell us if your donation is In Memory/Honor of someone; or if it should be designated for a specific program, project, or purpose. BrickMember Brick ($90)Non-Member Brick ($100)Brick InformationUsing the "Line" boxes below, please let us know what information you want included on your brick. Each brick can have up to 3 lines of text and each line can have a maximum of 14 characters (including all spaces and punctuation). Line 1* Line 2* Line 3* Total $0.00 Credit Card*Please check if you have activated a Stripe feed for your form. CommentsThis field is for validation purposes and should be left unchanged.
