Secure Online Donation Form

Membership Level Options:



Trustee Member: $100

  • Attend Halo Group board meetings as a Trustee/Board Member
  • One FREE drink ticket at each Happy Hour


Social Member $50

  • One FREE drink ticket at each Happy Hour


Payment Option

Pay my selected membership in full
I'd like to be on a $25 / mo. payment plan

Personal Information



First Name:
Last Name:
Address 1:
Address 2:
City:
ST:
Zip:
Phone:
Email:
Confirm Email:


Credit Card Information                    

Card Type
Credit Card Number:
3 Digit CVC Number:

Credit Card Number:
4 Digit CVC Number:

Name as it appears on card:
Expiration Date: (MM/YYYY) /


I authorize the Clayton Dabney Foundation to charge my credit card for the amount I entered above.






Do not click more than once unless you wish to make multiple donations.
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