girlFriends Membership Form

girlFriends is a volunteer group of 9th to 12th grade high school girls dedicated to fundraising throughout the school year for Children's Healthcare of Atlanta. girlFriends supports Children's through membership, volunteer opportunities, fundraising events and special service projects at our hospital campuses. You are invited to renew or begin your girlFriends membership below.

Contact Catherine Mojcik at catherine.mojcik@choa.org with any questions.

Field Is Required Select a Membership Level:

$40.00

girlFriends Member

Member Name

Member Birthday

Graduation Year

Billing Information

Title:

First Name:

Last Name:

Street 1:

Street 2:

City:

State/Province:

ZIP/Postal Code:

Country:

Email Address:

Yes! I want to be able to receive emails from Children's Healthcare of Atlanta Foundation staff, leaders, and programs.

Payment Information

Payment Method:

Credit CardChecking Account

Credit Card Information:

Credit Card Type:

Credit Card Number:

Expiration Date:Select month of credit card Select Expiration Year

CVV Number: What is this?

Checking Account Information:

Bank Routing Number: What is this?

Bank Account Number:

Verify Bank Account Number:

Account Type:

Checking
Savings

By checking this option, I agree to use my bank account as a payment method and authorize this organization to debit my bank account to fulfill my donation commitment.