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Personal Information

This section will collect your Personal Information needed to complete your transaction.

Title/Salutation
- Select - Mr. Ms. Mrs. Dr. Mr. & Mrs. Dr. & Mrs. Mr. & Dr. Drs. *
First Name(s)
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Last Name
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Company

Address
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Apartment/Unit/Building

City
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State
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Zip
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Phone Number
*
E-mail Address
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 Yes! Cass County Community Foundation may contact me at the e-mail address above.

 I prefer that this contribution remain anonymous.

Billing Information

 My Billing Information is the same as my Personal Information.

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Is this gift in memory or in honor of someone?

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 Pass Through Fund Donation

Payment Information

This information should match the credit card you intend to use for this transaction.
Name on Card (exactly as it appears)
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Card Type
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Card Number
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Expiration Date
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Card Security Code
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