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Donations - Secure Online Donation Form

Thank you for your donation to ACUPA!  It is sincerely appreciated and you will receive an acknowledgement upon processing of your donation.

Please note that your donation is not tax-deductible per IRS rules, as ACUPA is a 501(c)(6) organization.

Best,

T. Michael Ford

ACUPA Treasurer

Campaign/Fund Information
Campaign/Fund * The General Fund This Site Secured By SSL Encryption
Donation Information
Donation Amount *
Payment Method *
Donor Comments
Donor Information
First Name *
Middle Name
Last Name *
Suffix
Organization
Email *
Address *
Address Cont.
City/Town *
Country *
Location
Postal Code*
Phone *
Billing Information
[ Click here if billing address is the same as donor address ]
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Organization 
Address *
Address Cont.
City/Town *
Country *
Location
Postal Code*
Billing Phone *

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