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2018 Summer Sustaining Donor Drive
If you would like to enjoy the convenience of automatic recurring billing, simply complete the Credit Card Information section below and sign the form. All requested information is required. Upon approval, we will automatically bill your credit card for the amount indicated and your total charges will appear on your monthly credit card statement. All information submitted will remain confidential.

You may cancel this automatic billing authorization at any time by contacting Brian Cook by email at cook@revelsnorth.org or by calling 866-556-3083.

Thank you for helping us meet our Mid Year Appeal goal.

First Name *
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Last Name *
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Street *
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Town *
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State *
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Zip Code *
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Phone *
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Email Address *
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Monthly Donation Amount *
Is this gift to be anonymous? *
Credit Card Type *
All account information will be kept private.
Credit Card Number *
All account information will be kept private.
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Credit Card Expiration *
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Credit Card CVV# *
3 numbers on the back of your card
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