2011 Hurricane Irene Relief Donation Form

Your dollars will go towards relief efforts performed by NYAC volunteers, within the boundaries of the Annual Conference.

1. Payment by check: If you would like to send a check, please make it payable to "NYAC Storm Relief" and send to NYAC, Attn: Treasurer, 20 Soundview Ave, White Plains, NY 10606 . If you are donating by check, you do not need to fill out the form below.

2. Payment by credit card:Please fill out the form below to make a donation using your debit or credit card through PayPal (no account is required).
*First Name
*Last Name
*Email
Address
City
State
Zip
Your Church
Please choose your NYAC church from the drop-down list:
Other Affiliation If you are not a member of one of our churches, please let us know to which association you are affiliated, or how you heard about our relief efforts.
*Donation Amount ($1)
There are only 4020 available
Please put the dollar amount of your donation in the box. (Please do not use a dollar sign; use numerals only, not text.)
You Are Nearly Finished!
The total for your donation appears in the lower right corner of the screen. You can pay this by VISA, MasterCard, American Express or Discover through PayPal by clicking on the "Pay Now" button that will appear after you click the "Submit" button below. If prefer to pay by check, please make it payable to "NYAC Storm Relief" and send to NYAC, Attn: Treasurer, 20 Soundview Ave, White Plains, NY 10606. There is no need to submit this form if donating by check.
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