I want my donation to be:*
Deductible - to the Education Fund.
Non Deductible - used for Advocacy

Donation Amount*
$25.00
$50.00
$100.00
Other
Other Amount*

This Donation is*
A general donation
In memory of someone
In honor of someone
Memorial / Honorarium Name

Do you want us to notify anyone of this donation?
Yes
No
Please provide information about the person we should notify below

Name

First

Last
Address*

street Address

Address Line 2

City

State

Zip
Email

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Your Information

Are you a League member?*
Member
Non-Member

Name*

First

Last
Address*

street Address

Address Line 2

City

State

Zip
Email*

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Confirm Email
Phone Number*

Second Phone .




I will pay by*:
PayPal Check

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When you press Submit, your information will be submitted and an email will be sent to you with instructions for sending your check.