Champions for Quality Education Donation Form

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Invest in Schools. Ensure the Future.

Gift Information

Field Is Required Select Gift Amount:

$1,000.00

$500.00

$250.00

$100.00

$50.00

$25.00

Other

Enter amount

Gift type:

One-time gift

Sustaining gift

Select a Gift Duration:

Total Gift: 0.00

Field Is Required I want my donation to be designated toward the following:

Use my gift where it is needed most.

Direct my gift to:

School Name (optional)

Yes, this is an honor or memorial gift

Honor Gift Type:

Notification Recipient Name:

Notification Recipient Street 1:

Notification Recipient Street 2:

Notification Recipient County:

Notification Recipient City:

Notification Recipient State/Province:

Notification Recipient ZIP/Postal Code:

Message Body:

Yes, include the gift amount in the message.

Billing Information

Title:

First Name:

Middle Name:

Last Name:

Suffix:

Street 1:

Street 2:

City:

State/Province:

ZIP/Postal Code:

Country:

Email Address:

Yes, I would like to receive communication from Champions for Quality Education.

Email Interests: You may periodically receive email from us regarding the interests you select.

Champions for Quality Education

Academic and Enrichment Programs

Capital Improvement Committee

Payment Information

Credit Card Information:

Credit Card Type:

Credit Card Number:

Expiration Date:Select month of credit card Select Expiration Year

CVV Number: What is this?

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