Memorial/Tribute Donation

Make a gift to Citymeals-on-Wheels in honor of a special someone or in memoriam. Gifts in tribute of a loved one are acknowledged with a personal message sent via regular mail or email letting the person know about your donation.

Please complete the form below and select the “Continue to enter memorial/tribute info” button to process your donation.

If you’d like to mail in your gift, please print and complete this form or call us at (212) 687-1234.

Fields marked with an asterisk (*) are required.
I would like to make a one-time gift of:
$1,437 Weekend, holiday & emergency meals for two people for a full year $668 Support one homebound elderly person with meals on weekends for an entire year $334 A year of Saturday meals to an elderly neighbor $257 Four emergency food packages, each containing 75 non-perishable items $128 Twenty holiday meals $64 One Emergency Food Package providing 75 non-perishable food items $39 Six weekend meals $ - Other donation amount.
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Country*:	UNITED STATESAFGHANISTANALBANIAALGERIAAMERICAN SAMOAANDORRAANGOLAANGUILLAANTARCTICAANTIGUA AND BARBUDAARGENTINAARMENIAARUBAAUSTRALIAAUSTRIAAZERBAIJANBAHAMASBAHRAINBANGLADESHBARBADOSBELARUSBELGIUMBELIZEBENINBERMUDABHUTANBOLIVIABOSNIA AND HERZEGOVINABOTSWANABOUVET ISLANDBRAZILBRITISH INDIAN OCEANBRUNEI DARUSSALAMBULGARIABURKINA FASOBURUNDICAMBODIACAMEROONCANADACAPE VERDECAYMAN ISLANDSCENTRAL AFRICAN REPUBLICCHADCHILECHINACHRISTMAS ISLANDCOCOS (KEELING) ISLANDSCOLOMBIACOMOROSCONGOCOOK ISLANDSCOSTA RICACOTE D IVOIRECROATIACUBACYPRUSCZECH REPUBLICDENMARKDJIBOUTIDOMINICADOMINICAN REPUBLICEAST TIMORECUADOREGYPTEL SALVADOREQUATORIAL GUINEAERITREAESTONIAETHIOPIAFALKLAND ISLANDSFAROE ISLANDSFIJIFINLANDFRANCEFRENCH GUIANAFRENCH POLYNESIAGABONGAMBIAGEORGIAGERMANYGHANAGIBRALTARGREECEGREENLANDGRENADAGUADELOUPEGUAMGUATEMALAGUINEAGUINEA-BISSAUGUYANAHAITIHEARD / MCDONALD ISLANDSVATICAN CITYHONDURASHONG KONGHUNGARYICELANDINDIAINDONESIAIRANIRAQIRELANDISRAELITALYJAMAICAJAPANJORDANKAZAKSTANKENYAKIRIBATIKOREAKUWAITKYRGYZSTANLAOLATVIALEBANONLESOTHOLIBERIALIBYAN ARAB JAMAHIRIYALIECHTENSTEINLITHUANIALUXEMBOURGMACAUMACEDONIAMADAGASCARMALAWIMALAYSIAMALDIVESMALIMALTAMARSHALL ISLANDSMARTINIQUEMAURITANIAMAURITIUSMAYOTTEMEXICOMICRONESIAMOLDOVAMONACOMONGOLIAMONTSERRATMOROCCOMOZAMBIQUEMYANMARNAMIBIANAURUNEPALNETHERLANDSNETHERLANDS ANTILLESNEW CALEDONIANEW ZEALANDNICARAGUANIGERNIGERIANIUENORFOLK ISLANDNORTH MARIANA ISLANDSNORWAYOMANPAKISTANPALAUPALESTINIAN TERRITORYPANAMAPAPUA NEW GUINEAPARAGUAYPERUPHILIPPINESPITCAIRNPOLANDPORTUGALPUERTO RICOQATARREUNIONROMANIARUSSIAN FEDERATIONRWANDASAINT HELENASAINT KITTS AND NEVISSAINT LUCIASAINT PIERRE AND MIQUELONSAMOASAN MARINOSAO TOME AND PRINCIPESAUDI ARABIASENEGALSEYCHELLESSIERRA LEONESINGAPORESLOVAKIASLOVENIASOLOMON ISLANDSSOMALIASOUTH AFRICASOUTH GEORGIASPAINSRI LANKASUDANSURINAMESVALBARD AND JAN MAYENSWAZILANDSWEDENSWITZERLANDSYRIAN ARAB REPUBLICTAIWANTAJIKISTANTANZANIATHAILANDTOGOTOKELAUTONGATRINIDAD AND TOBAGOTUNISIATURKEYTURKMENISTANTURKS AND CAICOS ISLANDSTUVALUUGANDAUKRAINEUNITED ARAB EMIRATESUNITED KINGDOMUS MINOR OUTLYING ISLANDSURUGUAYUZBEKISTANVANUATUVENEZUELAVIET NAMVIRGIN ISLANDS, BRITISHVIRGIN ISLANDS, U.S.WALLIS AND FUTUNAWESTERN SAHARAYEMENYUGOSLAVIAZAMBIAZIMBABWE
Contact Information
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Payment Information
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CVV Number*:	This code provides an extra measure of security against credit card fraud. On most cards this code is the last 3 digits printed in the signature area on the back. On AmEx cards it is the 4 digits above and to the right of the card number on the front.
Credit Card Type*:	MasterCard American Express Discover Visa
Credit Card Expiration*:	January February March April May June July August September October November December 10 11 12 13 14 15 16
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