Donate to the Living Century Initiative

1. How would you like to give?

Sample Living Century Initiative Certificate

Select an amount:

Wish to give a different amount?

Enter amount and click update.

My donation is anonymous for purposes of any listing thanking supporters

You have chosen to donate:

$100 with a personalized certificate

Your donation will:

Purchase 1 cluster or 5 trees

Personalize your Living Century certificate

(Optional) Please enter the reason(s) for your donation:

In honor of:

In memory of:

Select your ancestral region (and city, if known):

City:

Dedication:

(Optional - would you like to add any other information about this gift, about the person being honored, or about your ancestral town? This information may be posted on the thank you page for the Living Century Initiative)

Who is this certificate being given by?

Include spouse, children, etc.

Please mail my certificate to:

Please allow two weeks processing time for all certificate requests.

My billing address
A different address

     Recipient's Name:

Address:
City: State: Zip:

    Country:

2. Payment Information

Payment Method

PLEASE SELECT YOUR CREDIT CARD TYPE BELOW (REQUIRED)

This is a required field First Name:

This is a required field Credit Card Number:

This is a required field First Name:

This is a required field Last Name:

This is a required field Credit Card Number:

This is a required field Expiry Date:

This is a required field CCV:

This is a required field Last Name:

This is a required field Expiry Date:

This is a required field CCV:

This is a required field First Name:

This is a required field Credit Card Number:

This is a required field First Name:

This is a required field Credit Card Number:

This is a required field Last Name:

This is a required field Expiry Date:

This is a required field CCV:

Billing Address

This is a required field Address Line 1:

Address Line 2:

This is a required field City:

This is a required field State:

This is a required field Zip:

This is a required field Country:

This is a required field Email address:

This is a required field Telephone Number:

Special Instructions:

Contributions are tax deductible to the fullest extent allowable by law.