I would like to make a one-time gift for the following amount:
Enter Donation Amount Here:*
    $ .00

OR

I would like to make a recurring gift.
Gift amount* X Recurring frequency = Total amount
    $ .00     X         =     $ .00

First name*

Last name*

Address*

Address2

City*

State*
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming

Zip*

Email*

Phone*
- - ext

Phone type*
Home Work Mobile

Matching Gift Information

Many employers match the donations of their employees to charitable organizations. Please check with the Human Resources department at your and/or your spouse's employer. If the employer uses a Matching Gift form, please complete and send it to: The Prodigy Project, 6000 Medlock Bridge Pkwy C-100, #198, Alpharetta, GA 30022.

If you know the following information regarding the matching gift, please complete.

Company name

Matching gift amount
$ .00