The form below is for an individual to contribute to WAIA. If you are making a contribution for a group please use this form: Group Contribution Form

AA Member Individual Contribution

$ Donation Amount:

Personal Info

First Name *

Last Name

Email Address *

Donor Phone *

Comments

Credit Card Info

This is a secure SSL encrypted payment.

Card Number *

CVC *

Name on the Card *

Expiration *

Billing Details

Country *

Address 1 *

Address 2

City *

State *

Zip / Postal Code *

Terms

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I am a member of Alcoholics Annonymous

Donation Total: $10

Washington Area Intergroup Association