Donation Amount*
  • $1,000 = Furnish homes for 5 families
  • $600 = Furnish homes for 3 families
  • $200 = Furnish a home for 1 family
  • $100 = Furnish a home for 1 couple
  • $65 = Furnish a home for 1 individual
  • Other $
Country*
State / Province*
Address*
City*
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Email*
Confirm Email*
Phone*
Amount*
$
Name on Card*
Card Number*
Additional Comments