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Donate Once {{handleFrequencyLabel('1m', 'Donate Monthly')}}

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Other Amount

Other Amount

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USD

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Campaign

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Fund

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Dedicate my donation in honor or in memory of someone

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Type

Honor

Memory

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Tribute Name *

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I would like to send an acknowledgment to someone.

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Acknowledgee Name is the same as the Recipient.

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Your information

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Secure Payment

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First Name *

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Last Name *

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Submit as a company

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Company Name

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Email *

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Address Line 1 *

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Address Line 2

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City *

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State/Province *

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Zip/Postal Code *

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Country

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Payment Details

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Secure Payment

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Card

ACH

Pay Later

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or enter your card details below

Cardholder First Name *

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Cardholder Last Name *

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Cardholder Email

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Card *

Swipe

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Billing address is the same as mailing address

Address Line 1

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Address Line 2

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City

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State/Province

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Zip

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Country

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Routing Number *

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Account Number *

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Account Type *

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Account Holder First Name *

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Account Holder Last Name *

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I will mail in a check or money order

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Please mail your payment to:
213 Middlebury Street
Goshen, IN 46526

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Amount:

{{donationAmountStr}}/month USD

({{amexDonationAmountStr}} USD for AMEX cards)

Secure Payment

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{{formatAmount(campaignStats.goalMeter.raisedAmount)}} Raised

Goal {{formatAmount(campaignStats.goalMeter.goalAmount)}}

{{campaignStats.goalMeter.raisedPercentage}}%

Raised

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Donors

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Registrants

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RAISED OF {{formatAmount(campaignStats.goalMeter.goalAmount)}}

{{campaignStats.goalMeter.raisedPercentage}}% RAISED

{{campaignStats.goalMeter.donorCount}} Donor{{campaignStats.goalMeter.donorCount > 1 ? 's':''}}

{{campaignStats.goalMeter.registrantCount}} Registrant{{campaignStats.goalMeter.registrantCount > 1 ? 's':''}}

Thank you for supporting us in keeping our community healthy!

213 Middlebury St., Goshen, IN 46528
(574) 534-3300

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ACH Payment Confirmation

Verify that your bank account information is accurate.

Total Amount

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Routing Number

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Bank Account Type

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Bank Account Number

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ACH payments may take up to 10 days to appear on your bank account statement.