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Donation
Contact Information
Name
*
First Name
Last Name
Spouse Name
First Name
Last Name
Organization/Employer
Phone
*
Email
Verify Email
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Affiliations
*
select one
HRBA Parent
St. Martins Parishioner
HRBA Alumni
Archdiocesan Supporter
Events Supporter
Other
Class Of
Other Affiliation
Category
*
select one
Donation
Pledge Payment
Campaign
*
select one
Esperanza Auction
Hispanic Heritage Celebration
Annual Appeal
General Donation
Memorial Donation
In Memory Of - Please Provide Name
Amount
*
$500
$250
$100
$50
$25
$
Donation Schedule
One Time
Monthly
Quarterly
Yearly
Weekly
Bi-Weekly
Bi-Monthly
Continue donating until
(mm/dd/yyyy)
Add 3% to my total amount to help cover the payment processing fees
