Date

     

     

     

    Your Details

    Salutation

    First Name

    Last Name

    Organization

     

     

    Contact Information

    Address

    City

    State

    Zip

    Email

    Please send my thank you via

     

    Your Donation

    Short Summary

     

    (For all fields showing "Pounds or # of items", please make sure you indicate "pounds" or "items" with your answer.

    Baby or Child items

    Books

    Clothing

    Diapers/Wipes

    Food/Toiletries

    Feminine Hygiene

    Housing Items

    Incontinence

    Medical

    Pet Food

    School Supplies

     

    Holiday specific giving...

    Thanksgiving

    Christmas

    Do you grant Williamsburg House of Mercy permission to photograph and share this donation on social media, our website/publications, the local paper, and other media outlets?

     

    We are so grateful for your support. Thank you for your donation of the above items!