Monthly Giving

 

Thank you for helping to conquer diabetes!

Please complete the following form to make a monthly donation through our secure website. You will only need to complete this form once and we will charge your pledge to your credit card each month. We will send you an e-mail each month to confirm that your monthly donation was made. You may change or cancel your monthly gift at any time.

Your Billing Information
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Want to receive our eNewsletter?  Required
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Honor or Memorial Information (optional)
 
Check this option to make this gift in honor or in memory of a loved one, and then enter the appropriate information in the fields that display. Check this option to make this gift in honor or in memory of a loved one, and then enter the appropriate information in the fields that display. Required
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Check this option if the person you are honoring is deceased. Check this option if the person you are honoring is deceased. Required
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Check this option to include the amount of your gift in the letter. Check this option to include the amount of your gift in the letter. Required
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Donation Amount
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Monthly Gift Amount: Required
Monthly Gift Amount: Monthly Gift Amount: Required radio button group.
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Monthly Gift Amount: Monthly Gift Amount: Required radio button group.
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Monthly Gift Amount: Monthly Gift Amount: Required radio button group.
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Monthly Gift Amount: Monthly Gift Amount: Required radio button group.
Required
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Gift type:
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  Total Gift: Use the Calculate button to view the total amount of all gift payments for your donation.
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Payment Information
 
Credit Card Type:

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