Gift Information

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Gift type:

One-time gift

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Total Gift: 0.00

Yes, make this an anonymous gift.

Recognition Name:

Yes, you can display the amount of my donation publicly

Personal Note:

Donor Information

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Donor Street 1:

Donor Street 2:

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Yes, I would like to receive communication from this organization.

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Billing Information

Specifies to use the donor information as the billing information

Title:

First Name:

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Last Name:

Suffix:

Street 1:

Street 2:

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Yes, I want 100% of my donation to go to Parkinson Society Southwestern Ontario. Please increase my amount by 3% to cover all credit card transaction fees.

Gift Information

Donor Information

Billing Information

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