StolenYouth · Donation Form

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Your Contact Information

Name

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First Name

Last Name

Include a spouse/partner as a joint donor for this donation?

If yes, your spouse will be included on tax receipts and acknowledgments for this gift.

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Spouse's Name

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If we have your permission to publicly acknowledge this contribution, how you would like your name(s) printed?

Email

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Address

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In Honor/In Memory Gifts

Is this gift in memory or in honor of someone?

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No

In Memory of

In Honor of

Is this gift anonymous?

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No

If your donation is specific, please choose from the options below.

Name for In Memory or In Honor of Gifts

Dedication

Should we notify anyone of this donation?

Select "yes" if you would like us to notify the individual (in honor of) or the family (in memory of) for this donation.

Yes

No

Who to Notify for In Honor/In Memory of Gift:

First Name

Last Name

Notification Email for In Honor/In Memory of Gift:

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Notification Address for In Honor/In Memory of Gift

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Payment Information

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