Donation amount (Required)

$36 Student/Senior

$50 Member

$100 Sustainer

$360 Double Chai

$1,000 Contributor

$3,600 Builder

$5,000 Sponsor

$10,000 Guardian

$25,000 Patron

$50,000 Defender

$100,000 Benefactor

$180,000 Champion

$

$36 Student/Senior

$360 Double Chai

$5,000 Sponsor

$50,000 Defender

$50 Member

$1,000 Contributor

$10,000 Guardian

$100,000 Benefactor

$100 Sustainer

$3,600 Builder

$25,000 Patron

$180,000 Champion

$

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Frequency: monthly donations of $100,000

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one donation

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YOUR CONTACT INFO (Required)

Jacob Stein

[email protected]

+1-202-555-0166

123 Main street, Apt 23

Anytown, NY 12222

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IN MEMORY OF (Optional)

John Smith

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Sally Smith

123 Main street, Apt 23

Anytown, NY 12222

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Jacob Stein

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Sally Smith

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