Items marked bold are required fields. |
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Title: |
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First Name: |
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Middle Name: |
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Last Name: |
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Enter address, city, state and postal code as filed with your credit card company. |
Address: |
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City: |
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Email: |
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Phone: |
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Fax: |
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Please use my gift for: |
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If you chose “Other,” above, please indicate in the Comments section, below, as to where you would like your gift directed. |
Comments: |
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Many companies sponsor matching gift programs to encourage employees to support their secondary schools. If your company has such a program that will match gifts to Bishop Dwenger please indicate below. |
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I will arrange to have my gift matched: |
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If yes, insert
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Donation Amount: |
$ |
Card Type: |
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Card Number: |
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CVV2: |
Click here for CVV2 information. |
Expiration Date: |
mm/yyyy
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By entering credit card information and pressing "Submit" you authorize Bishop Dwenger to charge your account the amount entered above. |
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If you have any questions or would prefer to make your credit card gift over the phone, please call 260-496-4775 or e-mail us at mschreck@bishopdwenger.com. |
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To send a check (made out to Bishop Dwenger High School) or credit card gift through the mail, please print this form, complete it, and mail to: |
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Office of Development
Bishop Dwenger High School
1300 E. Washington Center Road
Fort Wayne, IN 46825-4556
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