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Disaster Relief Fund – Donation Form

checked boxYes, I would like to help support those schools impacted by Hurricane Sandy.

Donor Information

Name: *
Chapter Number: *
Adviser: *
School: *
Phone: *..
E-mail: *
Please enter the email address to which you wish to have your
donation information sent.

Payment Options

Pay By Credit Card
Pay By Check/Money Order

Credit Card Payment Information

VeriSign SealPlease enter your information as it appears on your credit card.
This transaction is sent via a secure network and your credit card information is not stored on our servers.
Please contact communications@fbla.org with questions about this process.

Check/Purchase Order Payment Information

An e-mail will be sent to the address you entered above with a link you can use to download a Donation Form in PDF format. The email will also contain the information about where you are to send your donation by mail.
Please contact communications@fbla.org with questions about this process.
 
Donation Amount: *$.00
First Name: *
Last Name: *
Address: *
Address 2: *
City: *
State: *
Zip Code: *
Donation Amount: *$.00
Type of Card: *   American Express   Mastercard   Visa  
Card Number: *
Expiration Date: */MM/YYYY
 
 



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