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Contribute to Allies of MICAI

Entering your contact information allows the organization to acknowledge your generous contribution. Specify the contribution amount and an optional comment. Depending on the configuration, you may also be able to specify if this should be reported as anonymous (although your contact information is still required.) Click Proceed to Payment to finalize and pay by credit card or by printing an invoice and mailing a check.

In addition to your name, please enter your address, phone number and email address. This will allow us to contact you if necessary.
Contact Information
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Contribution Details

Contribution Date
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Amount (US$)
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Amount must be equal to or above US$ 1.00
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Comment
How do you want your name to appear in the contribution records?
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Notify

Do you want the Association to notify someone about your contribution?
Name
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Matching Gifts

Does your employer or your spouse's employer match gifts?    
 
 
 
Will you mail the form?    
 
 
Employer Name
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Employer Contact Person
Employer Contact Phone
Matching Terms

Additional Info

I am interested in learning about other opportunities to help support Mutual Insurance Companies Association of Indiana.
Please send me more information about including Mutual Insurance Companies Association of Indiana in my will or estate plans.

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