Aqua | Helping Hand Donation Form

Helping Hand Donation Form

Helping Hand is an assistance program funded by donations from Aqua customers like you that is designed to assist customers in need with their water and wastewater bills. This program is focused on customers within the communities Aqua serves across Pennsylvania. That way, neighbors can help neighbors directly in their own communities. One hundred percent of each donation goes directly to those who need it and the contribution is tax deductible.

How do I make a donation?

It’s easy. Please complete the form below and provide your Aqua account number, name and address, and select the frequency and amount of your donation. The Helping Hand program accepts donations starting at $1, and donations can be set up as a one-time contribution or as a recurring monthly transaction.

When can I cancel my donation?

Anytime. Just complete the form below and select “cancellation” as your donation type. Allow at least 30 days for your donation cancel to become effective.

First Name

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Last Name

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Address

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City

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State

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Zip Code

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Email Address

Field is required, and needs to be a valid email address.

16-Digit Account Number

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Donation Type

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One-Time Donation Amount

Please enter the amount of your one-time donation.

Monthly Donation Amount

Choose donation amount from the drop down: 1, $3, $5 or Other

Authorization

Field is required

I authorize Aqua to add this donation to my bill or cancel my previous donation.

Helping Hand Donation Form

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