Donations with shopping cart

Name
First Last
Email
Phone
1. Please select an account in the dropdown box below*
Amount you would like to give to this account.*
Comments*
Would you like to donate to another account?
- Yes
- No
2. Please select account #2 in the dropdown box below
Amount you would like to give to account #2
Comments*
Would you like to donate to another account?
- Yes
- No
3. Please select account #3 in the dropdown box below*
Amount you would like to give to account #3
Comments*
Would you like to donate to another account?
- Yes
- No
4. Please select account #4 in the dropdown box below
Amount you would like to give to account #4
Comments*
Would you like to donate to another account?
- Yes
- No
5. Please select account #5 in the dropdown box below
Amount you would like to give to account #5
Comments*
Total Donation
$0.00
Name
This field is for validation purposes and should be left unchanged.