RAISE: Funding research at ALS TDI

Back to Hayden, Colorado Cog Ride

Products Hayden, Colorado Cog Ride

The following error(s) occurred

An unexpected error occurred. All information about this error has been logged and the Site Administrator has been notified of the error. We apologize for any inconvenience.

Please select your options below

26 Mile Road Ride
Price $30
Options
Quantity
2nd Annual Cog Ride Registration
Price $30
Options
Quantity
5 Mile Downtown Fun Run
Price $30
Options
Quantity
Gravel Grinder Ride
Price $30
Options
Quantity
Please select an option

{{payWith}} Pay with Credit Card Pay with Credit Card

Pay with PayPal Pay with PayPal

Your Information

first name is required
last name is required
email is required invalid email, this field should be in the format 'user@example.com'
phone is required invalid phone
address is required invalid address
city is required invalid city
state/region is required
zip is required invalid postal code
country is required
relation to ALS is required
relation to ALS other is required invalid relation to ALS other

Payment

credit card number is required invalid credit card number
expiration month is required
expiration year is required
The Last 3 or 4 Digits on the back of the card
cvv is required invalid cvv, this field should be in the format of 3 or 4 digits only
invalid comment

 

 

Your Information

relation to ALS is required
relation to ALS other is required invalid relation to ALS other

Payment

invalid comment

{{model.Message}}

Please Review & Confirm your Transaction

Please review your information below. If you would like to make a change, please click here to return to the previous page.

Your transaction is not complete until you click the "COMPLETE TRANSACTION" button below.

Selected Option(s)

Item Price Options Quantity Sub Total
{{item.PurchaseOptionName}} {{item.PurchaseOptionCost|currency}} {{item.Options}} {{item.Quantity}} {{item.PurchaseOptionCost*item.Quantity|currency}}

Optional Donation Information

Amount: {{model.OptionalDonationAmount|currency}}

Credit Card Information

Amount: {{model.Amount|currency}}
Name on Credit Card: {{model.FirstName}} {{model.LastName}}
Credit Card Number: {{model.CreditCardNumber}}
Expiration Date: {{model.ExpirationMonth}}/{{model.ExpirationYear}}
CVV: {{model.CVV}}
Billing Information: {{model.FirstName}} {{model.LastName}}
  {{model.Address1}}
  {{model.City}}, {{model.StateAbbreviation}} {{model.ZipPostalCode}}
  {{model.CountryName}}
Phone Number: {{model.Phone}}
Email: {{model.Email}}

Additional Information

Relation to ALS: {{model.RelationToALS}} {{model.RelationToALSOther}}
I am interested in: {{model.InterestedIn}}
Notes/Comments: {{model.NotesComments}}

Thank You!

ALS TDI Transaction Summary

{{model.Message}}

{{model.AuthMessage}}

RECEIPT OF TRANSACTION

Transaction Confirmation ID:
{{model.Id}}
Date of Transaction:
{{model.DonationDate|aspDate|date:'MM/dd/yyyy HH:mm:ss'}}
Billing Information:
{{model.FirstName}} {{model.LastName}}
{{model.Address1}}
{{model.City}}, {{model.StateAbbreviation}} {{model.ZipPostalCode}}
{{model.CountryName}}
TRANSACTION TOTAL:
{{model.Amount|currency}}
Fair Market Value Received: {{model.Fmv|currency}}
Tax Deductible Value: {{model.TaxDeductibleValue|currency}}

Your email serves as a tax receipt, no goods or services were provided in exchange for this donation. 100% of this gift is tax deductible. To lower costs and to comply with IRS guidelines, a paper tax receipt and thank you letter will be sent to anyone who donates $250 or more. Please call our office at 617-441-7204 to request a paper copy. ALS TDI is a non-profit 501(c)3 organization whose tax ID number is 04-3462719. The contact person at ALS TDI for matching gift requests is Roxanne Murden who can be reached at 617.441.7204 or by email at rmurden@als.net.
Printable Version
Please take a moment to complete our online donation feedback survey. Your feedback is greatly appreciated!
http://www.surveymonkey.com/s/Donation_Feedback