subject_line
Is this a new, or additional commitment?
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New, I have not previously made a commitment but wish to participate.
Additional, I made a commitment earlier and want to commit an additional amount.
I INTEND TO GIVE:
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TIMING:
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One time gift
Weekly, for 156 weeks
Monthly, for 36 months
Annually, for 3 years
Other (including non-cash gifts)
Weekly Commitment
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Monthly Commitment
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Annual Commitment
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Additional Commitment
Please tell us the additional gift amount, over and above your original Together Campaign pledge.
Additional $Amount
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TIMING
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Add this amount to my existing Together Campaign schedule
Extend my existing gift to a fourth year
None of these apply, I'll describe my new schedule below
Other (including non-cash gifts)
Please describe:
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CONTACT INFO:
First Name
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Last Name
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Street Address
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City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Phone Number
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Email Address
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T
his commitment card is a statement of intent
and may be
modified as needed.