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Vision Centre Donation
Organizational Support
$100,000
-
Platinum
$50,000
-
Gold
$25,000
-
Silver
$10,000
-
Bronze
$
Individual Support
$10,000
-
Leader
$5,000
-
Contributor
$2,500
-
Builder
$1,000
-
Ambassador
$250
-
Patron
$100
-
Member
$
Reason for Donation
*
Organization/Employer
*
Contact Information
Name
*
First Name
Last Name
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Phone
*
Email
*
Verify Email
*
Additional Comments? (Optional)