Donor Form

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Donor Form

We want to thank you for your thoughtfulness and generosity to one or more of our programs. Being that we are a non-profit organization, ICBDA relies 100% on donation and public support. Please specify which programs you would like to support. If you wish to be anonymous, you may type anonymous for your name. Again, thank you for your support.

****After clicking submit button, you will receive a link and an email to submit your payment. Small transaction fee will be applied.*****

Email *

YYYY

Last Name *

First Name *

Address

City, State

Please direct my donation to one of the following programs:

Dr. Laurene Simms Award

Youth Empowerment Summit Y.E.S!

Junior Black Deaf Advocates

Black/Brown Interpreter Program

General Fund

Other:

Donation Amount:

$25.00

$50.00

$100.00

$300.00

$500.00

Other:

Clear selection

Thank you for your support!

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