American Camellia Society Donation, In Memoriam & Honorarium
Individual or Company/Corporation/Society/Club Donor?
*
Individual
Company/Corporation
Information about Individual(s) Making Donation
Name(s) of Individual(s) Making Donation - Donor(s)
*
Mr.
Mrs.
Ms.
Dr.
Title
First Name
Last Name
Name of Second Individual Making Donation - Donor(s)
Title: Mr, Mrs.
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country
*
Phone Number of Individual(s) Making Donation - United States
*
Cell Phone Number of Individual(s) Making Donation - United States
Phone Number of Individual(s) Making Donation - International
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-
Country Code
-
Area Code
Phone Number
Cell Phone Number of Individual(s) Making Donation - International
-
Country Code
-
Area Code
Phone Number
Email of Individual(s) Making Donation
example@example.com
Information about Company/Corporation Making Donation
Name of Company/Corporation
*
Name of Contact Person at Company/Corporation
*
Mr.
Mrs.
Ms.
Dr.
Title
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country
*
Phone Number of Contact Person
*
Cell Phone Number of Contact Person
Phone Number of Contact Person
*
-
Country Code
-
Area Code
Phone Number
Cell Phone Number of Contact Person
*
-
Country Code
-
Area Code
Phone Number
Email of Contact Person
example@example.com
Type of Donation
*
In Memoriam (In Memory Of)
Honorarium (In Honor Of)
American Camellia Society Endowment Bequest
Friends of Camellias Fundraising Campaign
Lois and Leon Silver Camellia Center Fund
W. C. Wyatt Massee Lane Gardens Endowment Fund
Grants
Temporarily Restricted
Unrestricted Donation
Regular Donation or Anonymous Donation?
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Regular
Anonymous
Matching Donation?
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No
Yes
Information for Person(s) Donation being made In Memory Of or In Honor Of
Name of Person(s) Donation Made In Memory Of or In Honor Of
*
Mr.
Mrs.
Ms.
Dr.
Title
First Name
Last Name
2nd Name of Person(s) Donation Made In Memory Of or In Honor Of
Mr.
Mrs.
Ms.
Dr.
Title
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country
*
Phone Number of Person(s) Donation Made In Memory Of or In Honor Of
Cell Phone Number of Person(s) Donation Made In Memory Of or In Honor Of
Phone Number of Person(s) Donation Made In Memory Of or In Honor Of
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Country Code
-
Area Code
Phone Number
Cell Phone Number of Person(s) Donation Made In Memory Of or In Honor Of
-
Country Code
-
Area Code
Phone Number
Email of Person(s) Donation Made In Memory Of or In Honor Of
example@example.com
Message to be sent to Person(s) Donation Made In Memory Of or In Honor Of - Optional
Information for Sponsor of Matching Gift
Name of Matching Gift Sponsoring Company/Corporation
*
Name of Contact Person
*
First Name
Last Name
Address of Sponsor for Matching Gift
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country
*
Email for Sponsor of Matching Gift
*
example@example.com
Special Instructions
Please verify that you are human
*
Click on "Submit" below. This will take you to the Checkout Page where you will enter the AMOUNT OF YOUR DONATION
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Submit
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