Donate

Please complete the form below to submit a donation to Choices Clinic of Laurel.  We also offer ACH Bank Draft Authorization as an alternative donation method.

*If you are a business interested in receiving a dollar-for-dollar tax credit through the Pregnancy Resource Act, print and complete the form attached below. Call us at 601-428-4357 if you have any questions related to the tax credit or the application process.

Pregnancy Resource Act Application

Donate Online
Name
Name
First
Last
Donation
Donation Type
Total

Credit Card
Address
Address
City
State/Province
Zip/Postal