One moment please...
3rd Annual Fund Run - 2019
Name of Student
*
You are donating on behalf of which GIS student?
Another Student?
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Are you donating on behalf of another student?
Yes
No
Additional Student Names
If yes, please add the names of the other GIS students.
Amount
*
$100
$50
$25
$10
$
Donation Distribution
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If you are donating on behalf of more than one student, please let us know how you'd like your donation divided.
Divide Equally
Custom - describe below
N/A - Donating on behalf of only 1 student
If custom, describe how we should divide your donation (for example, $20 to Joe Smith and $30 to Susie Smith)
Contact Information
Name
*
First Name
Last Name
Email
*
Verify 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
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