2018 Friends of Scouting Campaign

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Donation Levels 
  Level Range
    Golden Eagle Level 
$1,000 and up
    Support One Scout 
$650 - $999
    Leadership Level 
$250 - $649
    Mountaineer Level 
$150 - $249
    Supporter Level 
$50 - $149
* required information
Select Gift Frequency
I would like to make a one-time gift for the following amount:
:* $
I would like to make a recurring gift.
Gift Amount* # of Payments Payment Frequency Total Gift Amount
$ X = $
NOTE: This transaction will count as the first payment toward your total gift amount.

Donor Information
First Name:*
Last Name:*
Address Line 1:*
Address Line 2:
ZIP/Postal Code:*
Unit Type:
Unit Number:
Create Username and Password
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Security Question:*
Security Answer:*

Payment Information
Payment Method
:*   Explain
Credit Card Type:*
Credit Card Expiration:*

Billing Information
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If not please fill out the information below:

Matching Gift Information
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Will this donation be potentially matched?
If you know the following information regarding the matching gift, please complete.
Company Name:
Matching Gift Amount:$

Additional Information
This is a payment to an existing contribution?: Yes
Prospect ID Number from billing statement:
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