2022 Membership Drive

Membership Information Payment Choose amount

Annually

$25
Individual Membership
$50
Family Membership
$100
Business/Organization Membership
$
Enter custom amount

Write us a comment

Your comment

First Name

Last Name

Phone

Choose your country

Address

Address 2

Postal Code

City

State / Province

Please fix the errors above.

CARD BANK TRANSFER

Card Number

MM / YY

CVC Code

The 3-4 digits on the back of your credit card

Billing ZIP Code

Enter the Zip/Postal code for your credit card billing address

By clicking Donate, you authorise RUSSELLHEALTHCOALITION to debit the bank account that you connect to for any amount owed for charges arising from your use of RUSSELLHEALTHCOALITION’ services and/or purchase of products from RUSSELLHEALTHCOALITION, pursuant to RUSSELLHEALTHCOALITION’ website and terms, until this authorisation is revoked. You may amend or cancel this authorisation at any time by providing notice to RUSSELLHEALTHCOALITION with 30 (thirty) days notice.

If you use RUSSELLHEALTHCOALITION’ services or purchase additional products periodically pursuant to RUSSELLHEALTHCOALITION’ terms, you authorise RUSSELLHEALTHCOALITION to debit your bank account periodically. Payments that fall outside the regular debits authorised above will only be debited after your authorisation is obtained.

Bank Name

Account Type

Account Last 4

Donate from your bank using Plaid, a secure and encrypted bank transfer service.

Create a donor account to manage my donations and donate again faster.

Optionally add to cover processing fees

You can log in to edit your recurring donation any time

Russell County Health Coalition is a Section 501(c) (3) charitable organization, EIN 82-0825769. All donations are deemed tax-deductible absent any limitations on deductibility applicable to a particular taxpayer. No goods or services were provided in exchange for your contribution.