Donation Form
GEM*STAR CIRCLE OF EXCELLENCE SCHOLARSHIP PROGRAM
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
DONATION AMOUNT
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( X )
CAD
Description
Comments
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Payment Methods
Debit or Credit Card
Please click one of the PayPal options to complete payment and
submit
the form.
Submit
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