ESP Donations Form
Thank you for your support of our club. We could not work with the community to remove barriers to engaging in physical activity without your help.
DONATION AMOUNT
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( X )
NZD
We are a registered charity. Do you require a receipt for tax purposes?
*
Yes
No
Do you wish to remain anonymous?
*
Yes
No
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You only need to provide your personal information if you require a receipt and/or do not wish to remain anonymous.
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Email
example@example.com
Any comments/feedback you would like to offer?
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Pay with PayPal
Choose from one of the PayPal options to
make your payment.
Submit
Should be Empty: