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Your Donation is Greatly Appreciated - Mahalo! |
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Please provide all of the necessary information on this form so that we may process your donation. All donations are tax deductible (EIN # 87-0803687).
Your donation check should be made payable to:
St. Louis Class of 1987
Please PRINT THIS FORM AND MAIL IT to:
St. Louis Class of 1987 Attn: Keone Morreira 95-237 Hokuloa Loop Mililani, HI 96789 |
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Denotes Required Fields |
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| Gift Information | ||||||||||||||
| I want to contribute towards the following causes: | ||||||||||||||
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| *Gift Amount : | $ |
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| Donor Information | ||||||||||||||
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| *First Name: | ||||||||||||||
| *Middle Name: | ||||||||||||||
| *Last Name: | ||||||||||||||
| *I am a(n): | ||||||||||||||
*If OTHER, Please specify: |
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| *Class of: | ||||||||||||||
| *Home Address: | ||||||||||||||
| *City: | ||||||||||||||
| *State: | ||||||||||||||
| *Zip/Postal Code: | ||||||||||||||
| Contact Information | ||||||||||||||
| Please provide us with your home or business email address, so we may contact you if we have questions about your gift. | ||||||||||||||
| Email: | ||||||||||||||
Is this your
Home or
Business email address |
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| If you prefer that we contact you by phone, please provide a phone number. |
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| Home Phone: | ||||||||||||||
| Business Phone: | ||||||||||||||
| Credit Card Transaction Information | ||||||||||||||
| *Name
: (as it appears on credit card) |
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| *Credit Card Number: | ||||||||||||||
| *Card Type: | ||||||||||||||
| *Card Id: (Where is my Card ID?) | ||||||||||||||
| *Expiration Date: | ||||||||||||||
| * Personal Business | ||||||||||||||
| Other Information | ||||||||||||||
| *Permission to Publish: | ||||||||||||||
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| Matching Funds: | ||||||||||||||
| I (or my spouse) work for a matching gift company. | ||||||||||||||
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| I will arrange to have my gift matched: | ||||||||||||||
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If Yes, please insert Company Name:
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Company City: |
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Company
State: |
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| Please send me more information about: | ||||||||||||||
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