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Donation Form

Today's Credit/Debit Card Donation Amount:

I would like my donation to recur:

Yes

Amount you would like to recur:

Frequency of donation:

Number of recurrences:

Date of your final recurring donation:

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Please confirm recurring donation:

Will your company match your gift?

Yes

Do you currently have a student or relative who attends or works at St. Anthony School?

Yes

If you selected YES, please let us know the name of the Student or Staff Member:

Are you an alum or had a student attend St. Anthony School?

Yes

If you Answered YES, please let us know the year you or your student graduated:

Contact Information

Company:

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

Mobile Phone:

Home Phone:

Email:*

Credit Card Information

Card Types Accepted:
Visa

Credit Card Number:*

Card Security Code:*

Expiration Date:*

Electronic Signature:*

I agree to pay above total amount according to card issuer agreement. Once the transaction has completed successfully, a confirmation receipt will be sent to the email address entered.

One-Time Gift	Monthly Gift	Per Year Total	Annual Pledge	3-Year Total

$25,000	$1,000 month	$12,000 year	$25,000	$75,000

$10,000	$500 month	$6,000 year	$10,000	$30,000

$5,000	$250 month	$3,000 year	$5,000	$15,000

$2,500	$125 month	$1,500 year	$2,500	$7,500

$1,000			$1,000	$3,000

Other Amount

Donation Form

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