Welcome | Official Texas Fund for Veterans Assistance

<!DOCTYPE html> <html> <head><script type="text/javascript" src="/_static/js/bundle-playback.js?v=HxkREWBo" charset="utf-8"></script> <script type="text/javascript" src="/_static/js/wombat.js?v=txqj7nKC" charset="utf-8"></script> <script>window.RufflePlayer=window.RufflePlayer||{};window.RufflePlayer.config={"autoplay":"on","unmuteOverlay":"hidden"};</script> <script type="text/javascript" src="/_static/js/ruffle/ruffle.js"></script> <script type="text/javascript"> __wm.init("https://web.archive.org/web"); __wm.wombat("https://txapps.texas.gov/tolapp/fva/home.do","20180925070219","https://web.archive.org/","web","/_static/", "1537858939"); </script> <link rel="stylesheet" type="text/css" href="/_static/css/banner-styles.css?v=S1zqJCYt" /> <link rel="stylesheet" type="text/css" href="/_static/css/iconochive.css?v=3PDvdIFv" />   <script src="https://web.archive.org/web/20180925070219js_/https://www.google.com/recaptcha/api.js"></script> <title>Welcome | Official Texas Fund for Veterans Assistance | Texas.gov</title> <meta content="text/html;charset=UTF-8" http-equiv="Content-Type"/> <meta name="MSSmartTagsPreventParsing" content="TRUE"/>  <meta name="keywords" content="veterans,fund,donation,donate,assistance,veterans commission,tvc"/> <meta name="description" content="Help support Texas Veterans and their families by donating online to the Fund for Veterans' Assistance, a program offered by the Texas Veterans Commission."/> <meta name="viewport" content="width=device-width; initial-scale=1.0; maximum-scale=1.0; minimum-scale=1.0; user-scalable=0;"/> <link type="image/x-icon" href="/web/20180925070219im_/https://txapps.texas.gov/favicon.ico" rel="shortcut icon"/> <link rel="stylesheet" type="text/css" href="/web/20180925070219cs_/https://txapps.texas.gov/apps/vet/fva/css/style_app.css"> <link rel="stylesheet" type="text/css" href="/web/20180925070219cs_/https://txapps.texas.gov/apps/vet/fva/css/style_fva.css"> <link rel="stylesheet" type="text/css" href="/web/20180925070219cs_/https://txapps.texas.gov/apps/vet/fva/css/print.css" media="print"/> <script type="text/javascript" src="/web/20180925070219js_/https://txapps.texas.gov/apps/vet/fva/js/jquery-3.3.1.min.js"></script> <script type="text/javascript" src="/web/20180925070219js_/https://txapps.texas.gov/apps/vet/fva/js/jquery-ui.min.js"></script> <script type="text/javascript" src="/web/20180925070219js_/https://txapps.texas.gov/apps/vet/fva/js/global-fva.js"></script>  </head> <body> <div class="wrapper"> <div class="body-header"> <div class="body-header-content"> <a href="https://web.archive.org/web/20180925070219/http://www.texas.gov/" target="_blank">The Official Website of the State of Texas</a> </div> </div> <div class="body-center"> <div class="banner-wrapper"> </div> <div class="app-wrapper"> <div class="container-form"> <div class="container-content"> <form id="donations" class="default" action="home.do" method="post"> <input type="hidden" id="urchin_title" value="home.do"> <div class="error"> </div> <div class="banner-wrapper"> <img src="/web/20180925070219im_/https://txapps.texas.gov/apps/vet/fva/img/FVA_Collage.jpg" alt="Texas Fund for Veterans Assistance Placard" id="placard" class="noDisplayMobile"> </div> <h3>Give a little – Do a lot for Texas Veterans</h3> <p>With your donation, the Fund for Veterans’ Assistance improves the lives of Texas Veterans and their families.</p> <p>Your kindness helps:</p> <ul> <li>Veterans suffering from the invisible wounds of war to receive the therapy needed to take back control of their lives</li> <li>Military families on the verge of homelessness obtain access to safe housing</li> <li>Elderly and disabled Veterans to receive hot lunchtime meals</li> </ul> <p>For more information about the Texas Veterans Commission, visit our website at <a href="https://web.archive.org/web/20180925070219/http://www.tvc.texas.gov/" target="_blank">www.tvc.texas.gov</a>.</p> <h3>Donate by Credit Card</h3> <p>To make a donation by credit card, please enter the following information.</p> <fieldset id="Amount"> <legend>Donation Amount</legend> <ul class="list_form"> <li> <label for="amt">Amount<span class="offScreen">. Required. Minimum donation amount is $10.00.</span></label> <div id="amount" class="inputAndInstructions"> <p class="text_info">Required. Minimum donation amount is $10.00.</p> <div class="zipCodeInside">$ <input id="amt" name="amountStr" type="text" value="" size="7" maxlength="7"/>.00</div> </div> </li> </ul> </fieldset> <fieldset id="cardInfo"> <legend>Payment Information</legend> <p>Enter your credit card information.</p> <ul class="list_form"> <li> <label for="ccType">Credit Card Type<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <select id="ccType" name="creditCard.type"> <option value="" selected="selected">--</option> <option value="AMEX">American Express</option> <option value="DISC">Discover</option> <option value="MAST">MasterCard</option> <option value="VISA">Visa</option> </select> </div> </li> <li> <label for="ccNum">Credit Card Number<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <input name="creditCard.accountNumber" id="ccNum" maxlength="16" size="25" value="" autocomplete="off"/> </div> </li> <li> <label for="expires">Credit Card Expiration Date<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <div class="zipCodeInside"> <select id="expires" name="creditCard.expirationMonth"> <option value="" selected="selected">--</option> <option value="01">01</option> <option value="02">02</option> <option value="03">03</option> <option value="04">04</option> <option value="05">05</option> <option value="06">06</option> <option value="07">07</option> <option value="08">08</option> <option value="09">09</option> <option value="10">10</option> <option value="11">11</option> <option value="12">12</option> </select> <label for="expires_year" class="offScreen">  Credit Card Expiration Year. </label> <select id="expires_year" name="creditCard.expirationYear"> <option value="" selected="selected">--</option> <option value="2015">2015</option> <option value="2016">2016</option> <option value="2017">2017</option> <option value="2018">2018</option> <option value="2019">2019</option> <option value="2020">2020</option> <option value="2021">2021</option> <option value="2022">2022</option> <option value="2023">2023</option> <option value="2024">2024</option> <option value="2025">2025</option> <option value="2026">2026</option> </select> </div> </div> </li> <li> <label for="cvvNum">Credit Card Verification Code<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <input name="creditCard.cvv" id="cvvNum" maxlength="4" size="10" value="" autocomplete="off"/> </div> </li> <li> <div class="sampleCreditCard" style=""> <a href="sampleCreditCard.do" target="_blank">View Sample Credit Card</a> to locate your credit card verification code. </div> </li> </ul> </fieldset> <fieldset id="billingInfo"> <legend>Donor Billing Address</legend> <p>Enter your credit card billing address.</p> <ul class="list_form"> <li> <label for="billingPerson.title">Title</label> <div class="inputAndInstructions"> <p class="text_info"></p> <select id="billingPerson.title" name="billingPerson.title"> <option value="" selected="selected">--</option> <option value="Mr.">Mr.</option> <option value="Mrs.">Mrs.</option> <option value="Ms.">Ms.</option> <option value="Miss">Miss</option> <option value="Dr.">Dr.</option> <option value="Rev.">Rev.</option> <option value="The Honorable">The Honorable</option> <option value="None">None</option> </select> </div> </li> <li> <label for="billingPerson.firstName">First Name<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <input id="billingPerson.firstName" name="billingPerson.firstName" type="text" value="" size="25"/> </div> </li> <li> <label for="billingPerson.middleName">Middle Name</label> <div class="inputAndInstructions"> <p class="text_info"></p> <input id="billingPerson.middleName" name="billingPerson.middleName" type="text" value="" size="25"/> </div> </li> <li> <label for="billingPerson.lastName">Last Name<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <input id="billingPerson.lastName" name="billingPerson.lastName" type="text" value="" size="25"/> </div> </li> <li> <label for="billingPerson.suffix">Suffix</label> <div class="inputAndInstructions"> <p class="text_info"> </p> <select id="billingPerson.suffix" name="billingPerson.suffix"> <option value="" selected="selected"> -- </option> <option value="Jr.">Jr.</option> <option value="Sr.">Sr.</option> <option value="II">II</option> <option value="III">III</option> <option value="IV">IV</option> </select> </div> </li> <li> <label for="add01-billing">Address Line 1<span class="offScreen">. Required. Street Address or P.O. Box.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required. Street Address or P.O. Box</p> <input id="add01-billing" name="billingAddress.addressLine1" type="text" value="" size="25"/> </div> </li> <li> <label for="add02-billing">Address Line 2<span class="offScreen">. Apartment, Suite, Unit, Building, Floor, etc.</span></label> <div class="inputAndInstructions"> <p class="text_info">Apartment, Suite, Unit, Building, Floor, etc.</p> <input id="add02-billing" name="billingAddress.addressLine2" type="text" value="" size="25"/> </div> </li> <li> <label for="city-billing">City<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <input id="city-billing" name="billingAddress.city" type="text" value="" size="25"/> </div> </li> <li> <label for="state">State<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <select id="state" name="billingAddress.state"> <option value="" selected="selected"> -- </option> <option value="AK">ALASKA</option><option value="AL">ALABAMA</option><option value="AR">ARKANSAS</option><option value="AZ">ARIZONA</option><option value="CA">CALIFORNIA</option><option value="CO">COLORADO</option><option value="CT">CONNECTICUT</option><option value="DC">DISTRICT OF COLUMBIA</option><option value="DE">DELAWARE</option><option value="FL">FLORIDA</option><option value="GA">GEORGIA</option><option value="HI">HAWAII</option><option value="IA">IOWA</option><option value="ID">IDAHO</option><option value="IL">ILLINOIS</option><option value="IN">INDIANA</option><option value="KS">KANSAS</option><option value="KY">KENTUCKY</option><option value="LA">LOUISIANA</option><option value="MA">MASSACHUSETTS</option><option value="MD">MARYLAND</option><option value="ME">MAINE</option><option value="MI">MICHIGAN</option><option value="MN">MINNESOTA</option><option value="MO">MISSOURI</option><option value="MS">MISSISSIPPI</option><option value="MT">MONTANA</option><option value="NC">NORTH CAROLINA</option><option value="ND">NORTH DAKOTA</option><option value="NE">NEBRASKA</option><option value="NH">NEW HAMPSHIRE</option><option value="NJ">NEW JERSEY</option><option value="NM">NEW MEXICO</option><option value="NV">NEVADA</option><option value="NY">NEW YORK</option><option value="OH">OHIO</option><option value="OK">OKLAHOMA</option><option value="OR">OREGON</option><option value="PA">PENNSYLVANIA</option><option value="RI">RHODE ISLAND</option><option value="SC">SOUTH CAROLINA</option><option value="SD">SOUTH DAKOTA</option><option value="TN">TENNESSEE</option><option value="TX">TEXAS</option><option value="UT">UTAH</option><option value="VA">VIRGINIA</option><option value="VT">VERMONT</option><option value="WA">WASHINGTON</option><option value="WI">WISCONSIN</option><option value="WV">WEST VIRGINIA</option><option value="WY">WYOMING</option><option value="AS">AMERICAN SAMOA</option><option value="GU">GUAM</option><option value="MP">NORTHERN MARIANA ISLANDS</option><option value="PR">PUERTO RICO</option><option value="VI">VIRGIN ISLANDS</option><option value="AA">ARMED FORCES AMERICA</option><option value="AE">ARMED FORCES EUROPE</option><option value="AP">ARMED FORCES PACIFIC</option> </select> </div> </li> <li> <label for="zip-billing">ZIP Code<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <input id="zip-billing" name="billingAddress.zipCode" type="text" value="" size="5" maxlength="5"/> </div> </li> <li> <label for="country-billing">Country<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <select id="country-billing" name="billingAddress.country"> <option value="" selected="selected"> -- </option> <option value="US">UNITED STATES</option><option value="AF">AFGHANISTAN</option><option value="AX">ALAND ISLANDS</option><option value="AL">ALBANIA</option><option value="DZ">ALGERIA</option><option value="AS">AMERICAN SAMOA</option><option value="AD">ANDORRA</option><option value="AO">ANGOLA</option><option value="AI">ANGUILLA</option><option value="AQ">ANTARCTICA</option><option value="AG">ANTIGUA AND BARBUDA</option><option value="AR">ARGENTINA</option><option value="AM">ARMENIA</option><option value="AW">ARUBA</option><option value="AU">AUSTRALIA</option><option value="AT">AUSTRIA</option><option value="AZ">AZERBAIJAN</option><option value="BS">BAHAMAS</option><option value="BH">BAHRAIN</option><option value="BD">BANGLADESH</option><option value="BB">BARBADOS</option><option value="BY">BELARUS</option><option value="BE">BELGIUM</option><option value="BZ">BELIZE</option><option value="BJ">BENIN</option><option value="BM">BERMUDA</option><option value="BT">BHUTAN</option><option value="BO">BOLIVIA</option><option value="BA">BOSNIA AND HERZEGOVINA</option><option value="BW">BOTSWANA</option><option value="BV">BOUVET ISLAND</option><option value="BR">BRAZIL</option><option value="IO">BRITISH INDIAN OCEAN TERRITORY</option><option value="BN">BRUNEI DARUSSALAM</option><option value="BG">BULGARIA</option><option value="BF">BURKINA FASO</option><option value="BI">BURUNDI</option><option value="KH">CAMBODIA</option><option value="CM">CAMEROON</option><option value="CA">CANADA</option><option value="CV">CAPE VERDE</option><option value="KY">CAYMAN ISLANDS</option><option value="CF">CENTRAL AFRICAN REPUBLIC</option><option value="TD">CHAD</option><option value="CL">CHILE</option><option value="CN">CHINA</option><option value="CX">CHRISTMAS ISLAND</option><option value="CC">COCOS (KEELING) ISLANDS</option><option value="CO">COLOMBIA</option><option value="KM">COMOROS</option><option value="CG">CONGO</option><option value="CD">CONGO, THE DEMOCRATIC REPUBLIC OF THE</option><option value="CK">COOK ISLANDS</option><option value="CR">COSTA RICA</option><option value="CI">COTE D'IVOIRE</option><option value="HR">CROATIA</option><option value="CU">CUBA</option><option value="CY">CYPRUS</option><option value="CZ">CZECH REPUBLIC</option><option value="DK">DENMARK</option><option value="DJ">DJIBOUTI</option><option value="DM">DOMINICA</option><option value="DO">DOMINICAN REPUBLIC</option><option value="EC">ECUADOR</option><option value="EG">EGYPT</option><option value="SV">EL SALVADOR</option><option value="GQ">EQUATORIAL GUINEA</option><option value="ER">ERITREA</option><option value="EE">ESTONIA</option><option value="ET">ETHIOPIA</option><option value="FK">FALKLAND ISLANDS (MALVINAS)</option><option value="FO">FAROE ISLANDS</option><option value="FJ">FIJI</option><option value="FI">FINLAND</option><option value="FR">FRANCE</option><option value="GF">FRENCH GUIANA</option><option value="PF">FRENCH POLYNESIA</option><option value="TF">FRENCH SOUTHERN TERRITORIES</option><option value="GA">GABON</option><option value="GM">GAMBIA</option><option value="GE">GEORGIA</option><option value="DE">GERMANY</option><option value="GH">GHANA</option><option value="GI">GIBRALTAR</option><option value="GR">GREECE</option><option value="GL">GREENLAND</option><option value="GD">GRENADA</option><option value="GP">GUADELOUPE</option><option value="GU">GUAM</option><option value="GT">GUATEMALA</option><option value="GN">GUINEA</option><option value="GW">GUINEA-BISSAU</option><option value="GY">GUYANA</option><option value="HT">HAITI</option><option value="HM">HEARD ISLAND AND MCDONALD ISLANDS</option><option value="VA">HOLY SEE (VATICAN CITY STATE)</option><option value="HN">HONDURAS</option><option value="HK">HONG KONG</option><option value="HU">HUNGARY</option><option value="IS">ICELAND</option><option value="IN">INDIA</option><option value="ID">INDONESIA</option><option value="IR">IRAN, ISLAMIC REPUBLIC OF</option><option value="IQ">IRAQ</option><option value="IE">IRELAND</option><option value="IL">ISRAEL</option><option value="IT">ITALY</option><option value="JM">JAMAICA</option><option value="JP">JAPAN</option><option value="JO">JORDAN</option><option value="KZ">KAZAKHSTAN</option><option value="KE">KENYA</option><option value="KI">KIRIBATI</option><option value="KP">KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF</option><option value="KR">KOREA, REPUBLIC OF</option><option value="KW">KUWAIT</option><option value="KG">KYRGYZSTAN</option><option value="LA">LAO PEOPLE'S DEMOCRATIC REPUBLIC</option><option value="LV">LATVIA</option><option value="LB">LEBANON</option><option value="LS">LESOTHO</option><option value="LR">LIBERIA</option><option value="LY">LIBYAN ARAB JAMAHIRIYA</option><option value="LI">LIECHTENSTEIN</option><option value="LT">LITHUANIA</option><option value="LU">LUXEMBOURG</option><option value="MO">MACAO</option><option value="MK">MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF</option><option value="MG">MADAGASCAR</option><option value="MW">MALAWI</option><option value="MY">MALAYSIA</option><option value="MV">MALDIVES</option><option value="ML">MALI</option><option value="MT">MALTA</option><option value="MH">MARSHALL ISLANDS</option><option value="MQ">MARTINIQUE</option><option value="MR">MAURITANIA</option><option value="MU">MAURITIUS</option><option value="YT">MAYOTTE</option><option value="MX">MEXICO</option><option value="FM">MICRONESIA, FEDERATED STATES OF</option><option value="MD">MOLDOVA, REPUBLIC OF</option><option value="MC">MONACO</option><option value="MN">MONGOLIA</option><option value="MS">MONTSERRAT</option><option value="MA">MOROCCO</option><option value="MZ">MOZAMBIQUE</option><option value="MM">MYANMAR</option><option value="NA">NAMIBIA</option><option value="NR">NAURU</option><option value="NP">NEPAL</option><option value="NL">NETHERLANDS</option><option value="AN">NETHERLANDS ANTILLES</option><option value="NC">NEW CALEDONIA</option><option value="NZ">NEW ZEALAND</option><option value="NI">NICARAGUA</option><option value="NE">NIGER</option><option value="NG">NIGERIA</option><option value="NU">NIUE</option><option value="NF">NORFOLK ISLAND</option><option value="MP">NORTHERN MARIANA ISLANDS</option><option value="NO">NORWAY</option><option value="OM">OMAN</option><option value="PK">PAKISTAN</option><option value="PW">PALAU</option><option value="PS">PALESTINIAN TERRITORY, OCCUPIED</option><option value="PA">PANAMA</option><option value="PG">PAPUA NEW GUINEA</option><option value="PY">PARAGUAY</option><option value="PE">PERU</option><option value="PH">PHILIPPINES</option><option value="PN">PITCAIRN</option><option value="PL">POLAND</option><option value="PT">PORTUGAL</option><option value="PR">PUERTO RICO</option><option value="QA">QATAR</option><option value="RE">REUNION</option><option value="RO">ROMANIA</option><option value="RU">RUSSIAN FEDERATION</option><option value="RW">RWANDA</option><option value="SH">SAINT HELENA</option><option value="KN">SAINT KITTS AND NEVIS</option><option value="LC">SAINT LUCIA</option><option value="PM">SAINT PIERRE AND MIQUELON</option><option value="VC">SAINT VINCENT AND THE GRENADINES</option><option value="WS">SAMOA</option><option value="SM">SAN MARINO</option><option value="ST">SAO TOME AND PRINCIPE</option><option value="SA">SAUDI ARABIA</option><option value="SN">SENEGAL</option><option value="CS">SERBIA AND MONTENEGRO</option><option value="SC">SEYCHELLES</option><option value="SL">SIERRA LEONE</option><option value="SG">SINGAPORE</option><option value="SK">SLOVAKIA</option><option value="SI">SLOVENIA</option><option value="SB">SOLOMON ISLANDS</option><option value="SO">SOMALIA</option><option value="ZA">SOUTH AFRICA</option><option value="GS">SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS</option><option value="ES">SPAIN</option><option value="LK">SRI LANKA</option><option value="SD">SUDAN</option><option value="SR">SURINAME</option><option value="SJ">SVALBARD AND JAN MAYEN</option><option value="SZ">SWAZILAND</option><option value="SE">SWEDEN</option><option value="CH">SWITZERLAND</option><option value="SY">SYRIAN ARAB REPUBLIC</option><option value="TW">TAIWAN</option><option value="TJ">TAJIKISTAN</option><option value="TZ">TANZANIA, UNITED REPUBLIC OF</option><option value="TH">THAILAND</option><option value="TL">TIMOR-LESTE</option><option value="TG">TOGO</option><option value="TK">TOKELAU</option><option value="TO">TONGA</option><option value="TT">TRINIDAD AND TOBAGO</option><option value="TN">TUNISIA</option><option value="TR">TURKEY</option><option value="TM">TURKMENISTAN</option><option value="TC">TURKS AND CAICOS ISLANDS</option><option value="TV">TUVALU</option><option value="UG">UGANDA</option><option value="UA">UKRAINE</option><option value="AE">UNITED ARAB EMIRATES</option><option value="GB">UNITED KINGDOM</option><option value="UM">UNITED STATES MINOR OUTLYING ISLANDS</option><option value="UY">URUGUAY</option><option value="UZ">UZBEKISTAN</option><option value="VU">VANUATU</option><option value="VE">VENEZUELA</option><option value="VN">VIET NAM</option><option value="VG">VIRGIN ISLANDS, BRITISH</option><option value="VI">VIRGIN ISLANDS, U.S.</option><option value="WF">WALLIS AND FUTUNA</option><option value="EH">WESTERN SAHARA</option><option value="YE">YEMEN</option><option value="ZM">ZAMBIA</option><option value="ZW">ZIMBABWE</option> </select> </div> </li> <li> <fieldset class="radioButtonFieldSet"> <legend>Is your mailing address different?</legend> <div> <input id="yes" name="mailingDifferent" type="radio" value="true"/> <label for="yes" class="radioLabel">Yes</label> <input id="no" name="mailingDifferent" type="radio" value="false" checked="checked"/> <label for="no" class="radioLabel">No</label> </div> </fieldset> </li> </ul> </fieldset> <fieldset id="contactInfo"> <legend>Donor Mailing Information</legend> <p>Enter your mailing address.</p> <ul id="contactInfo-details" class="list_form"> <li> <label for="mailingPerson.title">Title</label> <div class="inputAndInstructions"> <p class="text_info"></p> <select id="mailingPerson.title" name="mailingPerson.title"> <option value="" selected="selected">--</option> <option value="Mr.">Mr.</option> <option value="Mrs.">Mrs.</option> <option value="Ms.">Ms.</option> <option value="Miss">Miss</option> <option value="Dr.">Dr.</option> <option value="Rev.">Rev.</option> <option value="The Honorable">The Honorable</option> <option value="None">None</option> </select> </div> </li> <li> <label for="mailingPerson.firstName">First Name<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <input id="mailingPerson.firstName" name="mailingPerson.firstName" type="text" value="" size="25"/> </div> </li> <li> <label for="mailingPerson.middleName">Middle Name</label> <div class="inputAndInstructions"> <p class="text_info"> </p> <input id="mailingPerson.middleName" name="mailingPerson.middleName" type="text" value="" size="25"/> </div> </li> <li> <label for="mailingPerson.lastName">Last Name<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <input id="mailingPerson.lastName" name="mailingPerson.lastName" type="text" value="" size="25"/> </div> </li> <li> <label for="mailingPerson.suffix">Suffix</label> <div class="inputAndInstructions"> <p class="text_info"> </p> <select id="mailingPerson.suffix" name="mailingPerson.suffix"> <option value="" selected="selected"> -- </option> <option value="Jr.">Jr.</option> <option value="Sr.">Sr.</option> <option value="II">II</option> <option value="III">III</option> <option value="IV">IV</option> </select> </div> </li> <li> <label for="add01-contact">Address Line 1<span class="offScreen">. Required. Street Address or P.O. Box</span></label> <div class="inputAndInstructions"> <p class="text_info">Required. Street Address or P.O. Box</p> <input id="add01-contact" name="mailingAddress.addressLine1" type="text" value="" size="25"/> </div> </li> <li> <label for="add02-contact">Address Line 2<span class="offScreen">. Apartment, Suite, Unit, Building, Floor, etc.</span></label> <div class="inputAndInstructions"> <p class="text_info">Apartment, Suite, Unit, Building, Floor, etc.</p> <input id="add02-contact" name="mailingAddress.addressLine2" type="text" value="" size="25"/> </div> </li> <li> <label for="city-contact">City<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <input id="city-contact" name="mailingAddress.city" type="text" value="" size="25"/> </div> </li> <li> <label for="state-contact">State<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <select id="state-contact" name="mailingAddress.state"> <option value="" selected="selected"> -- </option> <option value="AK">ALASKA</option><option value="AL">ALABAMA</option><option value="AR">ARKANSAS</option><option value="AZ">ARIZONA</option><option value="CA">CALIFORNIA</option><option value="CO">COLORADO</option><option value="CT">CONNECTICUT</option><option value="DC">DISTRICT OF COLUMBIA</option><option value="DE">DELAWARE</option><option value="FL">FLORIDA</option><option value="GA">GEORGIA</option><option value="HI">HAWAII</option><option value="IA">IOWA</option><option value="ID">IDAHO</option><option value="IL">ILLINOIS</option><option value="IN">INDIANA</option><option value="KS">KANSAS</option><option value="KY">KENTUCKY</option><option value="LA">LOUISIANA</option><option value="MA">MASSACHUSETTS</option><option value="MD">MARYLAND</option><option value="ME">MAINE</option><option value="MI">MICHIGAN</option><option value="MN">MINNESOTA</option><option value="MO">MISSOURI</option><option value="MS">MISSISSIPPI</option><option value="MT">MONTANA</option><option value="NC">NORTH CAROLINA</option><option value="ND">NORTH DAKOTA</option><option value="NE">NEBRASKA</option><option value="NH">NEW HAMPSHIRE</option><option value="NJ">NEW JERSEY</option><option value="NM">NEW MEXICO</option><option value="NV">NEVADA</option><option value="NY">NEW YORK</option><option value="OH">OHIO</option><option value="OK">OKLAHOMA</option><option value="OR">OREGON</option><option value="PA">PENNSYLVANIA</option><option value="RI">RHODE ISLAND</option><option value="SC">SOUTH CAROLINA</option><option value="SD">SOUTH DAKOTA</option><option value="TN">TENNESSEE</option><option value="TX">TEXAS</option><option value="UT">UTAH</option><option value="VA">VIRGINIA</option><option value="VT">VERMONT</option><option value="WA">WASHINGTON</option><option value="WI">WISCONSIN</option><option value="WV">WEST VIRGINIA</option><option value="WY">WYOMING</option><option value="AS">AMERICAN SAMOA</option><option value="GU">GUAM</option><option value="MP">NORTHERN MARIANA ISLANDS</option><option value="PR">PUERTO RICO</option><option value="VI">VIRGIN ISLANDS</option><option value="AA">ARMED FORCES AMERICA</option><option value="AE">ARMED FORCES EUROPE</option><option value="AP">ARMED FORCES PACIFIC</option> </select> </div> </li> <li> <label for="zip-contact">ZIP Code<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <input id="zip-contact" name="mailingAddress.zipCode" type="text" value="" size="5" maxlength="5"/> </div> </li> <li> <label for="country-contact">Country<span class="offScreen">. Required.</span></label> <div class="inputAndInstructions"> <p class="text_info">Required.</p> <select id="country-contact" name="mailingAddress.country"> <option value="" selected="selected"> -- </option> <option value="US">UNITED STATES</option><option value="AF">AFGHANISTAN</option><option value="AX">ALAND ISLANDS</option><option value="AL">ALBANIA</option><option value="DZ">ALGERIA</option><option value="AS">AMERICAN SAMOA</option><option value="AD">ANDORRA</option><option value="AO">ANGOLA</option><option value="AI">ANGUILLA</option><option value="AQ">ANTARCTICA</option><option value="AG">ANTIGUA AND BARBUDA</option><option value="AR">ARGENTINA</option><option value="AM">ARMENIA</option><option value="AW">ARUBA</option><option value="AU">AUSTRALIA</option><option value="AT">AUSTRIA</option><option value="AZ">AZERBAIJAN</option><option value="BS">BAHAMAS</option><option value="BH">BAHRAIN</option><option value="BD">BANGLADESH</option><option value="BB">BARBADOS</option><option value="BY">BELARUS</option><option value="BE">BELGIUM</option><option value="BZ">BELIZE</option><option value="BJ">BENIN</option><option value="BM">BERMUDA</option><option value="BT">BHUTAN</option><option value="BO">BOLIVIA</option><option value="BA">BOSNIA AND HERZEGOVINA</option><option value="BW">BOTSWANA</option><option value="BV">BOUVET ISLAND</option><option value="BR">BRAZIL</option><option value="IO">BRITISH INDIAN OCEAN TERRITORY</option><option value="BN">BRUNEI DARUSSALAM</option><option value="BG">BULGARIA</option><option value="BF">BURKINA FASO</option><option value="BI">BURUNDI</option><option value="KH">CAMBODIA</option><option value="CM">CAMEROON</option><option value="CA">CANADA</option><option value="CV">CAPE VERDE</option><option value="KY">CAYMAN ISLANDS</option><option value="CF">CENTRAL AFRICAN REPUBLIC</option><option value="TD">CHAD</option><option value="CL">CHILE</option><option value="CN">CHINA</option><option value="CX">CHRISTMAS ISLAND</option><option value="CC">COCOS (KEELING) ISLANDS</option><option value="CO">COLOMBIA</option><option value="KM">COMOROS</option><option value="CG">CONGO</option><option value="CD">CONGO, THE DEMOCRATIC REPUBLIC OF THE</option><option value="CK">COOK ISLANDS</option><option value="CR">COSTA RICA</option><option value="CI">COTE D'IVOIRE</option><option value="HR">CROATIA</option><option value="CU">CUBA</option><option value="CY">CYPRUS</option><option value="CZ">CZECH REPUBLIC</option><option value="DK">DENMARK</option><option value="DJ">DJIBOUTI</option><option value="DM">DOMINICA</option><option value="DO">DOMINICAN REPUBLIC</option><option value="EC">ECUADOR</option><option value="EG">EGYPT</option><option value="SV">EL SALVADOR</option><option value="GQ">EQUATORIAL GUINEA</option><option value="ER">ERITREA</option><option value="EE">ESTONIA</option><option value="ET">ETHIOPIA</option><option value="FK">FALKLAND ISLANDS (MALVINAS)</option><option value="FO">FAROE ISLANDS</option><option value="FJ">FIJI</option><option value="FI">FINLAND</option><option value="FR">FRANCE</option><option value="GF">FRENCH GUIANA</option><option value="PF">FRENCH POLYNESIA</option><option value="TF">FRENCH SOUTHERN TERRITORIES</option><option value="GA">GABON</option><option value="GM">GAMBIA</option><option value="GE">GEORGIA</option><option value="DE">GERMANY</option><option value="GH">GHANA</option><option value="GI">GIBRALTAR</option><option value="GR">GREECE</option><option value="GL">GREENLAND</option><option value="GD">GRENADA</option><option value="GP">GUADELOUPE</option><option value="GU">GUAM</option><option value="GT">GUATEMALA</option><option value="GN">GUINEA</option><option value="GW">GUINEA-BISSAU</option><option value="GY">GUYANA</option><option value="HT">HAITI</option><option value="HM">HEARD ISLAND AND MCDONALD ISLANDS</option><option value="VA">HOLY SEE (VATICAN CITY STATE)</option><option value="HN">HONDURAS</option><option value="HK">HONG KONG</option><option value="HU">HUNGARY</option><option value="IS">ICELAND</option><option value="IN">INDIA</option><option value="ID">INDONESIA</option><option value="IR">IRAN, ISLAMIC REPUBLIC OF</option><option value="IQ">IRAQ</option><option value="IE">IRELAND</option><option value="IL">ISRAEL</option><option value="IT">ITALY</option><option value="JM">JAMAICA</option><option value="JP">JAPAN</option><option value="JO">JORDAN</option><option value="KZ">KAZAKHSTAN</option><option value="KE">KENYA</option><option value="KI">KIRIBATI</option><option value="KP">KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF</option><option value="KR">KOREA, REPUBLIC OF</option><option value="KW">KUWAIT</option><option value="KG">KYRGYZSTAN</option><option value="LA">LAO PEOPLE'S DEMOCRATIC REPUBLIC</option><option value="LV">LATVIA</option><option value="LB">LEBANON</option><option value="LS">LESOTHO</option><option value="LR">LIBERIA</option><option value="LY">LIBYAN ARAB JAMAHIRIYA</option><option value="LI">LIECHTENSTEIN</option><option value="LT">LITHUANIA</option><option value="LU">LUXEMBOURG</option><option value="MO">MACAO</option><option value="MK">MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF</option><option value="MG">MADAGASCAR</option><option value="MW">MALAWI</option><option value="MY">MALAYSIA</option><option value="MV">MALDIVES</option><option value="ML">MALI</option><option value="MT">MALTA</option><option value="MH">MARSHALL ISLANDS</option><option value="MQ">MARTINIQUE</option><option value="MR">MAURITANIA</option><option value="MU">MAURITIUS</option><option value="YT">MAYOTTE</option><option value="MX">MEXICO</option><option value="FM">MICRONESIA, FEDERATED STATES OF</option><option value="MD">MOLDOVA, REPUBLIC OF</option><option value="MC">MONACO</option><option value="MN">MONGOLIA</option><option value="MS">MONTSERRAT</option><option value="MA">MOROCCO</option><option value="MZ">MOZAMBIQUE</option><option value="MM">MYANMAR</option><option value="NA">NAMIBIA</option><option value="NR">NAURU</option><option value="NP">NEPAL</option><option value="NL">NETHERLANDS</option><option value="AN">NETHERLANDS ANTILLES</option><option value="NC">NEW CALEDONIA</option><option value="NZ">NEW ZEALAND</option><option value="NI">NICARAGUA</option><option value="NE">NIGER</option><option value="NG">NIGERIA</option><option value="NU">NIUE</option><option value="NF">NORFOLK ISLAND</option><option value="MP">NORTHERN MARIANA ISLANDS</option><option value="NO">NORWAY</option><option value="OM">OMAN</option><option value="PK">PAKISTAN</option><option value="PW">PALAU</option><option value="PS">PALESTINIAN TERRITORY, OCCUPIED</option><option value="PA">PANAMA</option><option value="PG">PAPUA NEW GUINEA</option><option value="PY">PARAGUAY</option><option value="PE">PERU</option><option value="PH">PHILIPPINES</option><option value="PN">PITCAIRN</option><option value="PL">POLAND</option><option value="PT">PORTUGAL</option><option value="PR">PUERTO RICO</option><option value="QA">QATAR</option><option value="RE">REUNION</option><option value="RO">ROMANIA</option><option value="RU">RUSSIAN FEDERATION</option><option value="RW">RWANDA</option><option value="SH">SAINT HELENA</option><option value="KN">SAINT KITTS AND NEVIS</option><option value="LC">SAINT LUCIA</option><option value="PM">SAINT PIERRE AND MIQUELON</option><option value="VC">SAINT VINCENT AND THE GRENADINES</option><option value="WS">SAMOA</option><option value="SM">SAN MARINO</option><option value="ST">SAO TOME AND PRINCIPE</option><option value="SA">SAUDI ARABIA</option><option value="SN">SENEGAL</option><option value="CS">SERBIA AND MONTENEGRO</option><option value="SC">SEYCHELLES</option><option value="SL">SIERRA LEONE</option><option value="SG">SINGAPORE</option><option value="SK">SLOVAKIA</option><option value="SI">SLOVENIA</option><option value="SB">SOLOMON ISLANDS</option><option value="SO">SOMALIA</option><option value="ZA">SOUTH AFRICA</option><option value="GS">SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS</option><option value="ES">SPAIN</option><option value="LK">SRI LANKA</option><option value="SD">SUDAN</option><option value="SR">SURINAME</option><option value="SJ">SVALBARD AND JAN MAYEN</option><option value="SZ">SWAZILAND</option><option value="SE">SWEDEN</option><option value="CH">SWITZERLAND</option><option value="SY">SYRIAN ARAB REPUBLIC</option><option value="TW">TAIWAN</option><option value="TJ">TAJIKISTAN</option><option value="TZ">TANZANIA, UNITED REPUBLIC OF</option><option value="TH">THAILAND</option><option value="TL">TIMOR-LESTE</option><option value="TG">TOGO</option><option value="TK">TOKELAU</option><option value="TO">TONGA</option><option value="TT">TRINIDAD AND TOBAGO</option><option value="TN">TUNISIA</option><option value="TR">TURKEY</option><option value="TM">TURKMENISTAN</option><option value="TC">TURKS AND CAICOS ISLANDS</option><option value="TV">TUVALU</option><option value="UG">UGANDA</option><option value="UA">UKRAINE</option><option value="AE">UNITED ARAB EMIRATES</option><option value="GB">UNITED KINGDOM</option><option value="UM">UNITED STATES MINOR OUTLYING ISLANDS</option><option value="UY">URUGUAY</option><option value="UZ">UZBEKISTAN</option><option value="VU">VANUATU</option><option value="VE">VENEZUELA</option><option value="VN">VIET NAM</option><option value="VG">VIRGIN ISLANDS, BRITISH</option><option value="VI">VIRGIN ISLANDS, U.S.</option><option value="WF">WALLIS AND FUTUNA</option><option value="EH">WESTERN SAHARA</option><option value="YE">YEMEN</option><option value="ZM">ZAMBIA</option><option value="ZW">ZIMBABWE</option> </select> </div> </li> </ul> </fieldset> <fieldset> <legend>Donor Contact Information</legend> <ul class="list_form"> <li> <label for="phone">Phone Number</label> <div class="inputAndInstructions"> <p class="text_info"> </p> <input id="phone" name="mailingPhoneNumber" type="text" value=""/> </div> </li> <li> <label for="email">Email Address</label> <div class="inputAndInstructions"> <p class="text_info"> </p> <input id="email" name="mailingPerson.email" type="text" value=""/> </div> </li> </ul> </fieldset> <p>Please note: Donations are non-refundable.</p> <div class="g-recaptcha" data-sitekey="6Le3wTcUAAAAAOyPUBBTjvXttogQauUHNF5v0CIA"></div> <input id="submitBtn" type="submit" value="Make Donation" class="button" style="margin-top:10px;"/> </form> </div> </div> </div> <div class="container-support"> <p>For technical assistance with this application, please call 1-877-452-9060 or send an email to <a href="https://web.archive.org/web/20180925070219/mailto:support@texasgovhelp.com">Texas.gov Help</a>.</p> </div> </div> <div class="body-footer"> <div class="inner"> <div class="right"> <a href="https://web.archive.org/web/20180925070219/http://www.texas.gov/en/about/Pages/policies.aspx" title="Texas.gov Policies" target="_blank">Texas.gov Policies</a> | © 2011 <a 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