Campaign 132 Donation Form

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Goal {{formatAmount(campaignStats.goalMeter.goalAmount)}}

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Raised

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Donors

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Registrants

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RAISED OF {{formatAmount(campaignStats.goalMeter.goalAmount)}}

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{{campaignStats.goalMeter.registrantCount}} Registrant{{campaignStats.goalMeter.registrantCount > 1 ? 's':''}}

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Give Once {{handleFrequencyLabel('1m', 'Give Monthly')}}

Monthly gifts go further — cancel or pause anytime.

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USD

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Campaign

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Dedicate my donation in honor or in memory of someone

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Tribute Type

Honor

Memory

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Tribute Name

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Tribute Comment

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I would like to send an acknowledgment to someone.

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Acknowledgee Name is the same as the Recipient.

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Acknowledge To

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Address

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Acknowledgee Address Line 2

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City

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State

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Zip Code

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Tribute Donations

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If your donation is in honor or memory of someone or a team, please enter the name of the person or team being honored or remembered (Tribute Name).

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Tribute Notification

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If you would like the Run, Walk, Roll committee to notify someone of your tribute donation, please enter the name(s) and address below. You may also include a note that we will share.

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Comment

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First Name *

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Last Name *

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Email *

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Phone *

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Address *

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City *

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State *

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Zip *

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Cardholder Last Name *

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Cardholder Email

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Card *

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Address Line 1

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Address Line 2

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City

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State/Province

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Zip *

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Country

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I will mail in a check or money order

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Please mail your payment to:

947 Wayne Avenue

No. 110

Chambersburg , PA 17201

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Total Amount

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Choose monthly giving and
multiply your impact.

Your {{formatAmount(mgs.oneTimeAmount)}} gift matters. A recurring gift - at a lower amount - gives {{orgInfo.orgName}} the reliable support we need to deliver on our mission.

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Every gift goes directly toward our mission