Clone of Recurring Donation Subform

Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Donate to:

GeneralScholarship FundFund the FleetRidgehaus ProjectStaff (please specify below)
Additional Information
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Recurring Donation*

Monthly

USD for each month

Quarterly

USD for each three months

Yearly

USD for each year

Payment Method
Credit	Express