Field Is Required Select A Gift Amount:

$25.00

Funds drinking aids such as easy grip cups and long straws for one patient

$50.00

Funds a bed cane used to help a person with ALS turn while lying in bed

$100.00

Funds four hours of respite care to give the primary caregiver time away to help prevent burnout

$250.00

Pays for round trip transportation for a person with ALS to get to their appointment at the Lois Insolia ALS Clinic

$500.00

Funds a six foot ramp, allowing a person with ALS better access in and out of their home when they can no longer climb stairs

$1,000.00

Funds a communication device enabling people with ALS to communicate with their loved ones after they have lost their ability to speak

Enter amount

Billing Information

Billing Title:

Billing First Name:

Billing Middle Name:

Billing Last Name:

Billing Suffix:

Billing Street 1:

Billing Street 2:

Billing City:

Billing State/Province:

Billing ZIP/Postal Code:

Billing Country:

Email Address:

Communications Yes, I would like to receive emails from the Les Turner ALS Foundation.

Recognition

Recognition Name (Displayed publicly on personal/team honor roll):

Personal Note (Will be sent privately to walker/team captain):

Yes, you can display the amount of my donation publicly

Payment Information

Payment Method:

Credit CardChecking Account

Credit Card Information:

Credit Card Type:

Credit Card Number:

Expiration Date:Select month of credit card Select Expiration Year

CVV Number: What is this?

Checking Account Information:

Bank Routing Number: What is this?

Bank Account Number:

Verify Bank Account Number:

Account Type:

Checking
Savings

By checking this option, I agree to use my bank account as a payment method and authorize this organization to debit my bank account to fulfill my donation commitment.

Check Information

If you are using PayPal, click 'Donate' and you will be taken to the PayPal website to continue.

Double Your Impact!

Did you know your gift might be eligible for a matching gift from your employer? Search for your employer here and double, or even triple, your impact!

Find Your Employer: