United Spinal Association

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RECEIPT

Give an Honor or Memorial Gift Online

Thank you for making the commitment to give an honorary or memorial donation. VetsFirst is a program of United Spinal Association, a 501(c) (3) nonprofit membership organization dedicated to enhancing the lives of disabled veterans and their families.

You may make your gift by credit card by completing and submitting the information requested in this secure form.

$25.00

$50.00

$100.00

$250.00

Other Amount

Is this a Joint Gift?

Name:

Enter Joint Contribution Name here.

Optional Gift Notification:

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Gift made in the name of:

Your message to recipient:

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Message closing:

Message recipient name(s):

Recipient Address:

Address 2:

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Donor Infomation:

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This is the address where your credit card statements are mailed.

Address 2:

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A receipt will be e-mailed to this address.

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Your Payment Information:

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Expiration Date: *

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Account Number: *