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Donation Form
Amount
*
$1,000
$750
$500
$325
-
Suggested $200 to SOCNH + $125 to American Independence Museum
$200
-
Suggested Minimum Annual Contribution to SOCNH
$1,000
-
One-Time New Member Initiation Fee
$
Donation Schedule
One Time
Monthly
Quarterly
Yearly
Contact Information
Name
*
Prefix
First Name
Last Name
Suffix
Email
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Message to Treasurer:
Add 3% to my total amount to help cover the payment processing fees.
