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Email*

Street Address City State / Province / Region ZIP / Postal Code

I would like to pay the credit card fee associated with processing this gift! (Fee equals 2.9% of your contribution, plus 30 cents per transaction.)

Credit Card Processing Fee

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Transaction Fee

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Your Contribution

Your credit card will be charged the following amount when you hit "submit" on this form and again each month until you cancel your subscription.

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Your Contribution

Your credit card will be charged the following amount when you hit "submit" on this form and again each year until you cancel your subscription.

$0.00

Your Contribution

Your credit card will be charged the following amount when you hit "submit" on this form.

$0.00

Contribution Rules*

I confirm that the following statements are true and accurate:

I understand that State law requires that a contribution be in my name and be from my own funds. I hereby affirm that this contribution is being made from my personal credit card account, billed to and paid by me for my personal use, and having no corporate or business affiliation, and is not being made as a loan.
I am not a foreign national who lacks permanent residence in the United States.
I am at least eighteen years old.

Credit Card

Card Details

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