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Donation Form I want to become a donor to the American Red Cross – Flint River Chapter. My donation is: o - $100. o - $500. o - $150. o - $1,000. o - $200. o - Other __________ o - $250. _______ Check enclosed. _______ Send invoice. _______ I would like to pay in installments, please contact me. _______ Charge my credit card number _______________________________, expiration date _________________. o Visa o Mastercard Name ______________________________________________ Address _________________________________________________________ Email ______________________________ Phone_________________________ Signature ______________________________________________________ Please print, complete and mail this form to: 1509 Crawford Street, Americus, GA 31709
Thank you for your commitment……….. We cannot be here when we are needed the most without YOU!! |