XO Marriage Donation Form

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    My Best Gift

$

.00

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Please make this donation a:

One-Time Gift

First Name

Last Name

Email

Phone Number

Name on Account

Bank Name

Bank Routing Number

Bank Account Number

Account Type

CheckingSavings

Your Donation

$

Payment Information

I'd like to cover credit card fees. 

Email

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Name on Card:

   Card Number:

    MM

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Your Donation

$

Your Donation

$

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