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Donation
*
Mandatory fields
Personal Information
Prefix
*
First name
*
Last name
Suffix
Organization
Contact Information
*
Email
*
Phone
*
Street 1
Street 2
*
City
*
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
*
Zip/Postal Code
Donation Information
*
Amount ($USD)
*
Donation Type
End of Year Appeal
Gift Membership
In Honor of
In Memory of
Scholarship: Adopt-A-Class
Scholarship: Sponsor a Camper
Other (please explain below)
Donor Mailer
Yes
No
Contact Information for Gift Membership
Please list Gift Recipient:
* First Name
* Last Name
* Complete Address
* Phone number
* Email address
Gift Membership packages are sent to the gift recipient unless otherwise specified.
Contact Information for In Honor of Donation
We will send a letter to the recipient so please list their:
* First Name
* Last Name
* Complete Address
Contact Information for an In Memory of Donation
We will send a letter to their family so please list their:
* Name of individual who passed
* First Name
* Last Name
* Complete Address
*
Accessible Trail Support
Yes
No
*
Scout Service Project Support
Yes
No
Additional Information