Step 1 Amount

I want to make a

Single donation
Monthly donation

+ $50

+ $100

+ $250

Or donate another amount

Donate

Donate by mail

Global Lyme Alliance is a 501(c)(3) charitable organization. Tax ID is 06-1559393.

Step 2 Details

Your information

Title * First name * Last name * Email

This is a corporate donation

My company has a matching gift program

Company name

* Address #1 Address #2 Country * City

* State/Province

* Zip/Postal code Phone number

IS THIS DONATION IN tribute OF SOMEONE? Yes

Type of Tribute * First name Last Name Email

Do you want a notification sent?

Your Donation

Global Lyme Alliance is a 501(c)(3) charitable organization. Tax ID is 06-1559393.

Step 3 Payment

Credit card information

Same as personal details

* Card holder first name

* Card holder last name * Card account number * Expiration date ( Format: MMYY ) * Security code click here for CVV2 information

Billing address

* Address * Country * City

* State/Province

* Zip/Postal code

I understand that by submitting a donation, my information will be automatically added to GLA's secure database.

Your Donation

Global Lyme Alliance is a 501(c)(3) charitable organization. Tax ID is 06-1559393.

Step 4 Finish

Thank You

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Your Donation

Jesus Summers 8 (495) 358-23-75 French Southern Territories 20090042 52 Little Valley Suite 117

Total donated $250

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Global Lyme Alliance is a 501(c)(3) charitable organization. Tax ID is 06-1559393.