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Building Blocks Donation Form
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" indicates required fields
Donation Section
Name
*
First
Last
Email
*
Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
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Guam
Hawaii
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Maryland
Massachusetts
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Northern Mariana Islands
Ohio
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Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Current Selwyn Affiliation
Parent
Staff
Grandparent, Relative
Friend, Neighbor
Other
Student Name (if applicable)
First
Last
Student Teacher
Student's Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Do you have more Selwyn students?
No
Yes
Student #2 Name
First
Last
Student #2 Teacher
Student #2 Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Student #3 Name
First
Last
Student #3 Teacher
Student #3 Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Building Blocks - Donation Amount
Your donation is securely processed by our partner PayPal, Inc., which deducts approximately 3% as a transaction fee to cover credit card fees, bank fees, and other processing costs. Please consider chipping in an additional 3% so 100% of your donation goes to Selwyn Elementary.
Contribution Options - Select One
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Donate 100% - Add 3% to my donation so that 100% of the donation goes to Selwyn Elementary and covers the transaction fee that PayPal, Inc. charges.
Donate 97% - I understand PayPal, Inc. will deduct 3% to cover transaction costs and reduces the amount of the donation that goes to Selwyn Elementary.
Check made payable to Selwyn PTA.
PayPal Fee
Price:
$0.00
Donation Total
Donor Name(s) for donor recognition
Additional Giving Options
Is this donation eligible for corporate matching?
No
Yes
Match Amount (if eligible for corporate matching)
Company Name (if eligible for corporate matching)
Hard copy
Check if you wish to receive a hardcopy receipt of your contribution. Everyone will receive an electronic receipt via email.
ONCE YOU HIT SUBMIT, YOU WILL BE DIRECTED TO PAYPAL TO MAKE YOUR PAYMENT. PLEASE NOTE: ONCE YOU GET TO PAYPAL DONATION SCREEN THERE ARE TWO OPTIONS. IF YOU HAVE A PAYPAL ACCOUNT, SELECT "DONATE WITH PAYPAL". IF YOU WANT TO PAY WITH A CREDIT CARD, SELECT "DONATE WITH CARD".
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