Donation FormI want to make a secure online contribution (by credit card or through PayPal) to Unified Community Connections, which provides services that help children and adults with cerebral palsy and other disabilities live as independently as possible. Donation Amount* Name First Last Email PhoneTitleCompanyI would like to make this donation...In honor of...In memory of...Name First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Donation DesignationCrossroads CenterFrederick CenterHagerstown CenterCumberland CenterAssistive TechnologyDelrey SchoolGift SpecificsMailing List Please send me e-mails updating me about Unified Community Connections news and events. Finalize this transaction.Clicking the submit button below will redirect you to PayPal's secure servers where you can pay by credit card or through PayPal. A receipt of your donation will be sent to the email address you provided above. Please make sure this is a valid address. This iframe contains the logic required to handle Ajax powered Gravity Forms.