Dues to Donations
Primary Name Listed on Membership Account
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First Name
Last Name
Date of Birth
*
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Month
-
Day
Year
Date
Email Address (for donation receipt)
*
example@example.com
Preferred Contact Phone Number
*
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Area Code
Phone Number
Submission Date
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Month
-
Day
Year
Date
Electronically Sign Below: I authorize my YMCA membership dues to be converted to a tax-deductible donation during YMCA of Greater Oklahoma City facility closures. Conversion will begin with April dues.
*
Submit
Should be Empty: