Together, we create life-changing wishes
for children with critical illnesses

Donation Form

Donor Information
Name:

Phone:

Address:

City:

State:

ZIP:

Contribution Information
▢ Check/Money Order
Amount Enclosed: $

▢ Credit Card (please check card type)
▢ Mastercard®
▢ Visa®
▢ Discover®
▢ American Express®
Credit Card #:

Expiration:

Name:

(as it appears on credit card)
CVV Number:

(3-digit security code on back of card)
Designation
Please mail donations to:
Make-A-Wish® New Hampshire
814 Elm Street Suite 300
Manchester, NH 03101-2230
Please mail donations for another chapter or Make-A-Wish America to:
Make-A-Wish America®
Gift Processing Center
1702 E. Highland Avenue
Suite 400
Phoenix, AZ 85016
To make a donation to a Make-A-Wish® affiliate outside of the U.S., please visit www.worldwish.org.

If you'd like to donate via donor advised fund, please reach out to your financial advisor or your local Make-A-Wish chapter.
Contribution Information