DONATION CENTER

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Personal Information

First Name:	First Name:    (optional)
Last Name:	Last Name:    (optional)
Company:
Phone Number:	x    Home Mobile Office Fax
Email Address:
Address:
City:
State
Zip Code:

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Gift Information

Gift Amount:	$50 $100 Other $
Gift Type:	One Time Gift Monthly Gift (to be billed) not a monthly gift 3rd of each month 20th of each month
In Response to:	Filling the Food Gap Annual Campaign Newsletter Other Matching Gift (organization) Please send your matching gift form by mail - click here for more information Tribute - please include tribute information below If there is specific information you would like to include with your donation, please type it in the “Notes” field in the Tribute section below. GO GREEN! I would like to receive my tax deductible receipt by email Note: If unchecked, Kalamazoo Loaves & Fishes will send the donation receipt to the mailing address listed above.  If you do not want a receipt, please indicate that in the 'Notes' field below.

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Tribute Information

This gift is not a tribute in memory of in honor of If you have additional information please include it in the notes section below Please notify the following person of this contribution:   Name:   Address:   City/State:   Notes: