Friends of Dusty Pierpoint - Online Contributions by eFundraising Connections

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1 Contribution

$10
$25
$50
$100
$500
$1000
$ Other

Please select a contribution amount

Iterations

This recurring donation will process on 25th of every month.

2 Personal Information

Phone

First Contributor

First Name

Last Name

Company Name

Second Contributor

First Name

Last Name

Joint Address

Address

City

State

Zip

First Contributor

I am retired

Employer

Occupation

If you have no occupation or employer, do not leave blank. For occupation use general terms such as 'manager', 'homemaker', or 'none.' If not employed by a company, use terms such as 'self', 'retired', or 'unemployed.'

Employer City

Employer State

Second Contributor

I am retired

Employer

Occupation

Employer City

Employer State

3 Payment Method

Credit Card Number

MM/YY

Security

Your credit card verification code (CVC) is a 3 or 4 digit number. It can be found on the back of your card.

My credit card address is different than my home address.

CC Zip

Comment

By contributing you agree to the terms and conditions.

Some fields are invalid. Please see errors below corresponding fields.

Unable to process with ACH. Please check your routing/account number or choose another payment method

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Please input a value between $1.00 and $1000.00

Iterations may not exceed 32000

Total recurring amount plus merchadise may not exceed $1000.00. Please reduce the number of iterations, or reduce the payment amount.

Time span must not be past credit card's expiration date

Please select this before proceeding

Iterations must be a number greater than 0

Total donation amount may not exceed $1000.00. Please reduce the number of iterations, or reduce the payment amount.

Yes! Include processing fee (+${data-translate-1}). (Click to include fee in total).

Thank you! Processing fee has been included in your total.

Weeks

Months

Quarters

Years

PayPal accepted

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