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Supporting Diabetes Foundation of Mississippi
Your Donation
Donation Option
*
One-Time
Monthly
per month
Yearly
per year
Donation Amount
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Donation Amount
*
$
/
Maximum Amount to Donate (Optional)
$
Total
Is this donation in memory or honor of someone?
*
Yes
No
Please check whether donation is a Memorial or in Honor of someone
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Memorial
Honorarium
Whom is gift In Memory or Honor of:
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Whom to notify of your gift
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Address for remembrance or tribute notification
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How do you wish the gift notification to be signed?
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Corporate Giving
Individual Gift
Gift on behalf of my company
Employer Name
Company Name
Payment
Payment Method
*
{accountType} ending in {accountLastFour}
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Choose a different way to pay
Choose a different way to pay
Contact Details
Name
*
First Name
Last Name
Show my name as (Optional)
Email Address
*
Title
Region (eg. Jackson, North, Meridian, etc.
Team Name
Team Captain
Donate with Credit Card
Donate {amount}
Donate with Bank Account
Venmo
description
Yes! I’d like to cover processing costs. (
per month
per year
per
)
Set a time limit on monthly donations?
*
No
Yes
Donate for
*
Months
Enter a duration between 2 and 99 months.