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Donation
Name
*
First name
Last name
Company or Organisation
Email address
*
Phone Number
Donation Amount
*
$10.00
$25.00
$50.00
$100.00
$250.00
$500.00
$1,000.00
$2,500.00
Other amount
$
$10.00
$25.00
$50.00
$100.00
$250.00
$500.00
$1,000.00
$2,500.00
Other
$
Recurring period
*
One time
Weekly
Every 2 weeks
Once per month
4 Weekly
3 Monthly
6 Monthly
Annually
Pay/Donate method
*
If you are making a direct credit please include (donation) in reference
Stripe
Direct Credit
Make deposit to account
06-0807-0980345-00
Please check the highlighted fields
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