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Contribute to Club Sponsor - Silver Level $100-$249

Entering your contact information allows the organization to acknowledge your generous contribution. Specify the contribution amount and an optional comment. Depending on the configuration, you may also be able to specify if this should be reported as anonymous (although your contact information is still required.) Click Proceed to Payment to finalize and pay by credit card or by printing an invoice and mailing a check.

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Contact Information

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Donate as an

IndividualBusiness/Organization

First Name

Middle Initial

Last Name

Address 1

Address 2

City

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State/Province

Zip/Postal Code

Phone

Mobile Phone

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Email Address

Organization

Work Title

Contribution Details

Contribution Date

Amount (US$)

Amount must be between US$ 100 and US$ 249

Comment

How do you want your name to appear in the contribution records?

Notify

Do you want the Club to notify someone about your contribution?

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Name

Address Line 1

Address Line 2

City

Country

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State/Province

Zip/Postal Code

Additional Info

I am interested in learning about other opportunities to help support Swim Out.

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Please send me more information about including Swim Out in my will or estate plans.

YesNo

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