Chairman's Information

First Name

Last Name

Suffix

Jr., Sr., Etc.

Date of Birth

Age

Phone

Address

Address Line 1	Address Line 2
City	State/Province
Zip Code	Country

Donation Information

Total Pledge Amount

Payment Amount Today

Date of First Payment

Installment Period

Payment Method

My Employer will match my gift

Yes No

Employer Name

Match Gift Amount

Payment Information

Name on Card

Card Number

Code

Zip Code (Billing zip if paying by CC)

Payment Information

Please Mail Gifts To:

Delta Waterfowl
Attn: Whittlee LaMontagne
1412 Basin Avenue
Bismarck, ND 58504

Payment Information

Please Contact Whittlee LaMontagne at wlamontagne@deltawaterfowl.org or Delta Waterfowl, 1412 Basin Avenue, Bismarck, ND 58504 for:

U.S. Charitable Wire Transfer
CAN Charitable Wire Transfer
U.S. Stock Transfers
CAN Stock Transfers

Authnet_Hidden_Fields

Delta Waterfowl Foundation is a 501cs non-profit U.S. (EIN: 53-0259796) and a Canadian (RCO#: 119058998 RR0001) Registered Charitable organization dating to 1911. Delta provides leading-edge research and science-based solutions that efficiently conserve waterfowl and secure the future for waterfowl hunting. Your gift will be used to provide greatest benefit for waterfowl conservation and hunting on your behalf.