Cloud Regional Header  
Fighting for Air Online
 
 
 
Step 1
Donation & Payment Information
 

Make a Donation That Will Save Lives

Since 1904, the American Lung Association has been saving lives by helping people quit smoking, funding research, advocating for healthy air, and educating millions about asthma. Our work is possible only through public donations. Make a donation now to help all Americans breathe easier.

To send donations via mail, print this form and mail it to:

American Lung Association
822 John St
Seattle, WA  98109

Design Your Donation
* Radio button group Required
Select Donation Amount: Required
Select Donation Amount: Select Donation Amount: Required radio button group.
Required
Warning
     
Select Donation Amount: Select Donation Amount: Required radio button group.
Required
Warning
     
Select Donation Amount: Select Donation Amount: Required radio button group.
Required
Warning
     
Select Donation Amount: Select Donation Amount: Required radio button group.
Required
Warning
     
Select Donation Amount: Select Donation Amount: Required radio button group.
Required
Warning
     
Select Donation Amount: Select Donation Amount: Required radio button group.
Required
Warning
     
Select Donation Amount: Select Donation Amount: Required radio button group.
Required
Warning
*
Donation type:
Warning
 
Warning
  Total Donation: Use the Calculate button to view the total amount of all gift payments for your donation.
Warning

Make your gift go twice as far - search below to find out if your employer will match your gift to the American
Lung Association.  Check with your HR Department for more information about matching gifts.

 

 
Warning
Enter the name of your employer to find out if they will match your gift.
Billing Information
 
Warning
*
Warning
 
Warning
*
Warning
 
Warning
*
Warning
 
Warning
*
Warning
*
Warning
*
Warning
 
Warning
*
Warning
 
For your privacy, subscribers can unsubscribe using any email or login to change email preferences. For your privacy, subscribers can unsubscribe using any email or login to change email preferences. Required
Warning
 
Check this box if you want this site to remember you when you return. Check this box if you want this site to remember you when you return. Required
Warning
Payment Information
 
Credit Card Type:

Warning
*
Warning
* What is this?
Warning
*
Warning
Transaction Summary
Transaction Date: 4/16/14
Design Your Donation
Amount: ($0.01)
Matched Employer:
Billing Information
Title:
First Name:
Middle Name:
Last Name:
Suffix:
Street 1:
Street 2:
City:
State/Province:
ZIP/Postal Code:
Country:
Email opt-in: No
Remember me: No
Payment Information