Online Donations
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Donor Information
* = required
Full Name *
Address Line 1 *
Address Line 2  
City *
State/Province *
Postal/Zip Code *
Daytime Telephone *
E-Mail *
Please indicate how you would like your name(s) to appear in our Donor Listings.
I would like to remain anonymous
Credit Card Information
I would like to contribute:
Total Donation Amount (US$) *
Please debit my credit card *
Monthly         with payment/installments of   (Amount US$)
One-time Gift  
Please keep my credit card details on file for any installment payments
Credit Card Type *
Credit Card Number *
Expiration Date *   *
Name on Card *
Directed Donations
* I would like this gift to be directed to:
Summer 2021 increased cost of providing an in-person program
Family Emergency Fund
Other (Please Specify)
Matching Gifts?
Please indicate whether your employer or your spouse's employer will match your gift.
  Yours | Spouse | Organization Name(s)
Yes, matching form will be sent later
No, matching not available  
Please mail your matching gift form to:

Ginny Pracilio
Office Manager & Development Coordinator
Horizons at New Canaan Country School
635 Frogtown Road
New Canaan, CT 06840

P: (203) 972-7005
F: (203) 972-2732

Thank you for your contribution!

In Honor / Memory of
I would like this gift to be in Honor / Memory of:
      In Honor   In Memory
  Please send an acknowledgment of my gift to:

Thank You! Your receipt will be mailed to the above address.

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