Contact Us

 

Use this form for PER LAP DONATIONS ONLY.
If you'd like to make a fixed amount donation, please use this link.

Pledge an amount for each lap the Racing4Research car completes. For example, if you pledge 10 cents per lap and we drive 600 laps then your total donation will be $60.00. After the race we will calculate your pledge amount based on the official race results and contact you to debit your card. Should the Racing4Research car not finish at least 50% of the race, we will use the combined total of laps completed by the Farnbacher Loles cars not to exceed 650 laps.

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Personal Information (name and address must match credit card billing info)

 

 

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*Last Name:
 

*Email:

 

Company/Affiliation:

 

(i.e. PCA)

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*City:

 

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*Phone:

 

     
Payment Information

 

 

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*Expiration Date:

 



All donations are tax deductible and eligible for corporate matching gift programs.