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"*" indicates required fields

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50%

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Mailchimp Source

OC Donation

One Time Gift*

Give Once

Give Monthly

Donation Information

Donation Amount*

$25

$50

$100

$500

$1000

Other

Other Donation Amount:*

I would like my donation to benefit:

Other Designation

Please indicate the program or project you would like to direct this donation to

Specific County

Please indicate which county you'd prefer your gift to be used in.

Allowing your gift to be publicly recognized can help inspire others and increase the impact you have on the lives of others.

This donation is to be anonymous. Please do not print my name in the paper or other agency publications.

Allowing your gift to be publicly recognized can help inspire others and increase the impact you have on the lives of others.

Dedicate this gift to a friend or loved one

My gift will be matched by my employer

Dedicate this gift to:

First Last

Dedication Type:

Please notify the following of this contribution:

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Special Message

Name of Employer:*

Donor Information

Name*

First Last

Name(s) for Donation Recognition (if different from above)

Public Acknowledgement

To help inspire others, my donation may be made public

Please keep my gift anonymous

Email Address*

Enter Email Confirm Email

Email address required for online payment and receipt. You will not be added to the Opportunity Council mailing list unless you opt-in below for email updates.

We will not share your data and you can unsubscribe or adjust your contact preferences at any time.

Please send me email updates on how my donation makes a difference with the Opportunity Council

We will not share your data and you can unsubscribe or adjust your contact preferences at any time.

Phone

This field is hidden when viewing the form

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Total Donation Amount

The amount your credit card will be charged today.

Payment Method

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number Expiration Date Security Code Cardholder Name

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Entry Date

MM slash DD slash YYYY

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Option

Phone

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Donation Information

Donor Information

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Maple Alley Inn is for everyone.