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Your Information Required fields marked with *
*First Name:
*Last Name:
give as a company or organization
*Country:
*Address:
Apt:
*City:
*State / Province:
*Postal Code:
*Email:
*Phone:
-
-
Account Information
*Amount $
(U.S.)
*Purpose:
*Frequency:
*Draft Date:
Note:
*Account:
Checking (most effective)
Savings (most effective)
Credit Card
*Routing #:
*Account #:
Example Check Click image for help
*Card Type:
*Card Number:
*Name on Card:
*Expiration:
/
Billing Address is different from Mailing Address
*Country:
*Address:
Apt:
*City:
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*Postal Code:
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“Thank you for your partnership in helping draw the hearts of father’s, father figures, and children together! And a special note of thanks to those of you partnering through monthly electronic giving, the assurance that we have funding every month enables us to continue investing time into the lives of others through Family Lines.”