Individual Donation
Donation amount: $ 10.00 15.00 20.00 25.00 30.00 40.00 50.00 75.00 100.00 125.00 150.00 200.00 250.00 300.00 400.00 500.00 750.00 1000.00 2000.00 2500.00 3000.00

Billing Address	Payment Information
Cardholder First Name *: You must enter a cardholder	Cardholder Last Name *:  You must enter a cardholder
Address Line1*:   You must enter an Address	Address Line2:
City*:   You must enter a City	State*:   DE PA MD NJ NY VA AL AK AZ AR CA CO CT FL GA HI ID IL IN IA KS KY LA ME MA MI MN MS MO MT NE NV NH NC ND OH OK OR RI SC SD TE TX UT VT VA WA D.C WV WI WY
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Method of Payment:  MasterCard Visa Discover	Credit Card #*:  You must enter a credit card #
Card Expiration Month*:  January February March April May June July August September October November December	Card Expiration Year*:   2014 2015 2016 2017 2018 2019 2020 2021
CVV Code*:  You must enter a CVV code