Please print out and complete the form below. Then fax to (803) 254-0119 or mail to Ronald McDonald House Charities of Columbia,1529 Hampton Street, Suite 201 Columbia SC 29201. All information in bold is required.
Type of contribution ‚ individual ‚ business
Name
Business Name
Address
City|State|Zip
Phone
Fax
email
Payment Type check credit card If contributing with your credit card, please ensure that all information below is associated with the credit card you use.
Card Type
VISA MasterCard American Express
Card #
Expiration Date
MM/YY example: 10/06
Name on Card
Check the box if you wish to remain anonymous ‚
