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Donation Information
Amount
*
$250
$100
$50
$25
$15
$10
$
Donation Schedule
Monthly
Quarterly
Yearly
Continue donating until
(mm/dd/yyyy)
Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Phone Number
*
Phone Type
*
Home
Mobile
Work
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Is this gift anonymous?
Yes, I prefer to make this donation anonymously.
Matching Gift Program
My employer will match my gift.
Employer / Company Name
Is this a tribute gift?
No
Yes, this gift is in honor of someone
Yes, this gift is in memory of someone
Name of the person this tribute gift is honoring
First Name
Last Name
Name of the person this tribute gift is in memory of
First Name
Last Name
May we notify the honoree of your gift?
No
Yes
Honoree's Email Address
Verify Email
Honoree's Mailing Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
May we notify a family member or friend of your gift?
No
Yes
Name of family member or friend to be notified
First Name
Last Name
Family or Friend's Email Address
Verify Email
Family or Friend's Mailing Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Comments (e.g. additional donor names)
Would you like to be added to the CLCC email list for up-to-date information on conservation news around the state?
Yes
No
I am already on the CLCC email list.
Add 3% to my total amount to help cover the payment processing fees