Donor Information
Name
*
Mr.
Mrs.
Ms.
Dr.
Prefix
First Name
Last Name
Suffix
Phone Number
*
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Gift Information
Gift Amount ($)
*
This donation is for the Summer Camp campaign.
I'd like to help cover the 3% transaction fee associated with my contribution.
I'd like to dedicate my donation in honor or in memory of someone.
I'd like to make my donation a recurring, monthly donation, rather than a one-time gift.
I'd like my donation to remain anonymous.
New Gift Amount (with 3% transaction fee)
*
*
In Honor
In Memory
Honoree/Memorial Name
*
First Name
Last Name
Would you like to send notice to the honoree of your donation?
*
Yes
No
Acknowledgment Name
*
First Name
Last Name
Acknowledgment Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is there a particular message you'd like included?
*
Calculation
Monthly Calculation
One-time Calculation
Donation Notes
Donation Amount
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( X )
USD
Description
Credit Card
Submit
Notes
Date
-
Month
-
Day
Year
Date
Should be Empty: