Ambulance Association Fund Drive

Payment for Ambulance Association Fund Drive

Please enter information on this form to donate to the Ambulance Association Fund Drive .

First Name *

Last Name *

names of persons in home (with ages) *

Organization

Address *

Address2

City *

State *

Zip *

Country *

Phone *

Email *

Amount you would like to give *

Total Amount

Payment procesing fee

Gross Amount

Payment method

Paypal

Billing Zipcode*

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*

Mont Alto Vol. Fire Company:
517 South Main Street
Mont Alto, PA 17237
Phone: 717-749-5151 E-mail: info@montaltofire.com
Mont Alto Ambulance Squad:
603 South Main Street
Mont Alto, PA 17237
Phone: 717-749-3453 E-mail: ambulanceassoc@montaltofire.com
Non-Emergency:
State Police 717-264-5161 County Dispatch 717-263-3172
Police/Fire/Medical Emergency:
CALL 911