How to Give
Note: * = required field
Please choose how you want to invest in your community (select one):
General Donation
Walk the Talk for Epilepsy!
 
Personal information:
Prefix
* First name
* Last name
* Address
* City
* State/province
* Zip/postal code
Telephone number
Format: (xxx) xxx-xxxx
* E-mail address
Employer
 
My online donation:
* Donation amount ($): $.00
* Card Type:
Visa MasterCard AMEX Discover
* First name on card
* Last name on card
* Credit / check card #
* Expiration date  / 
Month /  Year
* Zip code on card
   
Miami
7300 N Kendall Dr Ste 700
Miami FL 33156-7840
Phone (305) 670-4949
Fax (305) 670-0904
Fort Lauderdale
512 NE 3rd Avenue
Fort Lauderdale FL 33301
Phone (954) 779-1509
Fax (954) 779-1549
West Palm Beach
3222 Commerce Place Ste B
West Palm Beach FL 33407
Phone (561) 478-6515
Fax (561) 687-9318
Jacksonville
5209 San Jose Blvd Ste 101
Jacksonville FL 32207
Phone (904) 731-3752
Fax ((904) 730-2329
Gainesville
1000 NW 8th Ave
Gainesville FL 32601
Phone (352) 378-4324
Fax (352) 378-4227