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Donation Form
Amount
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$1,000
$500
$250
$100
$50
$25
$
Recurring Gift
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Fund
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General
Layne Staley Fund
Is this Gift related to our Raising Power Fall 2020 Virtual Event?
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If yes, your gift may be matched for up to $20,000.
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Yes
No
Anonymous Gifting
I would like this gift to remain anonymous
Would you like to Dedicate this gift in Honor or Memory of Someone?
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Who would you like to dedicate the donation to?
Does Your Employer provide Gift Matches?
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Who is your Organization/Employer?
Contact Information
Name
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First Name
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Email
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Address
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