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Donor
Information:
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Name
____________________________________________
Address __________________________________________
City, State, Zip ____________________________________
Phone __________________ E-mail ________________________
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Gift
Information:
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Check
in the amount of $ _________________ enclosed
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Credit
Card in the amount of $ ____________________
Credit Card
Type: ___________________________________________
(VISA, MasterCard, or American Express)
Credit Card No.: ______________________________________________
Expiration Date: ____ / ______
Name as it appears on card: ___________________________________
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Gift
Of Securities
Security: ___________________________________________
Number of Shares: ______________________________________________
(We will contact you to arrange for transfer of securities.)
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Gift
Details:
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My
employer will match my contribution. __________________________________________
Employer Name. (Please enclose matching gift form.)
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I/We
prefer to be listed as anonymous.
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Please
send me information on bequests and other means of deferred and planned
giving.
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Mail
To: |
American Red Cross
Colonial Virginia Chapter
1317 Jamestown Road #105
Williamsburg, VA. 23185
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If
you are using your credit card, you may fax this form to (757)
253-2396. For questions about other gifts you'd like to give, please
call (757) 253-0228.
Thank
you for your gift to the
Colonial
Virginia Chapter of the American Red Cross.
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