Your donation can be made in memory or honor of someone.  In the Gift Information section below, list the name of the individual(s) you are making the gift in memory/honor of along with the name and address of the person we should notify.

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Personal Information
Prefix:   *First Name:   Middle:   *Last Name:   Suffix:
                       
Address Information
*Address:
   
*City:
*State:
*Zip:
     
 
*Phone:
  *Email:
  Reference Code:
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Comments:
Gift Information
If your donation is in memory or honor of someone, please be sure to include the name of the individual(s), along with the name and address of the person we should notify.
Payment Information
NOTE: The charge will appear on your statement as 'Caritas247' and your email receipt will be sent from mailserver@episode49.com.

*Amount: $     
  *Card Type:     *Security Code:     Security Code?
  *Credit Card#:     *Expiration Date:  

 

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