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APTP Donation
Amount
*
$2,500
$1,000
$500
$300
$100
$50
$
Donation Schedule
One Time
Monthly
Yearly
Continue donating until
(mm/dd/yyyy)
Gift Description
Please provide any description or note you would like added to your gift
Contact Information
Name
*
First Name
Last Name
Spouse/Partner Name
First Name
Last Name
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Email
*
Verify Email
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Phone
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Is there a company that will match your donation?
Matching gift company name
Is this gift made in honor or in memory of someone?
No
Yes, this is an honorary gift
Yes, this is a memorial gift
This gift is in honor of:
First Name
Last Name
Contact info of honoree if you would like them to be notified:
This gift is in memory of:
First Name
Last Name
Name and contact info of family/friend to be notified:
Yes! Please add 3% to my total donation to help cover APTP's processing fees
