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Monthly Giving Club Support
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First Name
Last Name
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*

Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
Student's Info
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code

First Name
Last Name




Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Donation Information
Note: Special incentives associated with our Monthly Giving Club starts at $18/mo.
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Monthly
Note: In choosing Yes, your name will NOT appear in our Annual Report's Honor Roll of Supporters.
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example: John & Jane Doe
Incentives (For $18+/mo support)