Fields marked with an asterisk (*) are required.
Donor Information
*Donation Amount: (ex: xxx,xxx.xx)
Donor Type:
Donate As:
Required only if the donation is being made In Memory Of or On Behalf Of someone.
*Donor Name:
*Mailing Address Line 1:
Address Line 2:
*City:
*State:
*Zip Code: (ex: xxxxx-xxxx)
*Phone Number: (ex: xxx-xxx-xxxx)
Email Address: (ex: address@host.com)
A Specialty Car Tag is available for purchase at your local Probate Office. It's tax deductible and proceeds directly fund community-based prevention programs. Thinking about a Personalized tag for your car? Click on the Plate!
*Payment Method:   Credit Card
  Electronic Check (ACH)
 
Technical Support: 866-353-3468 or support@alabamainteractive.org




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