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Donation goal

Collected: $11,637.24
Goal: $20,000.00
58%


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Donation

* Mandatory fields
*First Name
*Last Name
*Email
*Phone
*Primary Address
*City
*State
*Zip Code
Only whole numbers are accepted.
*County
*Employer
*Occupation
If you are Retired, please enter "Retired" as your Occupation
Suffix
*Date of Birth
...
*Amount ($USD)
Payment frequency
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