2020 LEAD Food Drive Donation Form

2020 LEAD Food Drive Donation Form
Email*
First Name*
Middle (optional)
Last Name*
Company or Organization Name*
(if individual please put NA)
Choose your donation amount*

$10$25$50$100Choose your own amount
Would you like to cover the processing fees (2.9%)?*

YesNo
base donation
Total donation plus fees
Total Calculation

My donation total*

USD

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Questions, please contact D’Lawrence White

at 757-391-3503
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