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Donation Form
Title:	Dr. Fr. Mr. Mrs. Ms. Rev.
First Name*
Last Name*
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Amount of Donation* (Format for "other" amount does not include dollar signs, commas, or decimal point.)	$10.00 $25.00 $50.00 $60.00 Will provide a 2 week supply of food for 5 families $100.00 Will help with a utility or rent bill $150.00 Help with medical needs Other
I would like this donation to be used for	-- Any Available Progams -- Where Needed Most Food Pantry
Donation	One time donation I would like to make this a recurring monthly donation
Privacy	Provide my name and e-mail address to the charity I prefer to make this contribution anonymously
Designation (optional)	To designate your donation for a specific purpose, please enter a description of how you'd like your donation to be used.
Dedication (optional)	To make a donation in memory of another person, please enter the person's name To make a donation in honor of another person, please enter the person's name
Questions/Comments
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