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$5500
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Please select an even decimal contribution amount if giving as a couple.
Please provide your Occupation and employer information. If you are self-employed, please provide Job Title and Name of company or Full first and last name.
ie; Occupation: Photographer, Interior Designer, Web Technician
Employer: John Doe
CVC on Visa/MasterCard/Discover is a 3 digit code on the back of the card. CVC on AMEX is a 4 digit code on the front of the card.
Total donation amount may not exceed $5500.00
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