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Recurring Donation Form

Monthly Donation*
Do you wish to make a recurring monthly donation?
- Yes
- No
*
First Name Last Name
Street Address Address Line 2 City State ZIP Code
Phone
Email*
Monthly Donation Amount*
The "+" amount is the amount added to the base of $25. It is not in addition to the total checked.
Amount
Total
$0.00
Credit Card*
Card Details
Cardholder Name