Bisous Alternate Payment Bisous Alt Payment Form To donate with a credit card, click here. Name* First Last E-mail*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Cell Phone*My gift will be made by:CheckDonor Advised FundCommunal FundStock TransferInternational Currency$54 Couvert Per person – 100% of all donations go to support Sharsheret I am attending Number of Attendees*Names of AttendeesSponsorship Levels $5,000 – Financial support for three women going through treatment $2,500 – Healthy living, nutrition, and fitness package for 25 cancer survivors $1,800 – Genetic and mental health counseling for 5 men/women $1,000 – Makeup kits and tutorials for 10 women $720 – A semester of educational programming related to cancer and genetics at one college campus $360 – 6 Busy Box Kits with toys, games and parenting resources for families $180 – Caregiver information kit and family counseling session $72 – Heidi Weisel Robe for comfort post treatment Total Amount (Couvert and Sponsorship):