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Welcome to NAMI Indiana's Online Donations. We appreciate your donation and support!
Amount
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$30
$50
$100
$500
$1,250
$
Donation Schedule
One Time
Monthly
Quarterly
Yearly
Contact Information
Name
*
First Name
Last Name
Email
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Address
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Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Phone number
This is a joint gift from myself and:
Would you like to make this gift in honor/in memory of someone?
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Yes, in honor of someone.
Yes, in memory of someone.
No, thank you.
This donation is in honor of(4010):
This donation is in memory of(4010):
Name of Next of Kin
So that we may notify them, do you know the address for the next of kin?
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
So that we can notify them, please let us know the address of the person you are honoring
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Optional Note
Would you like to include a message with this gift?