Chesapeake Planned Giving Council [CPGC]

DONATION

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* Mandatory fields

*First Name

*Last Name

*Position/Job Title

*Organization Name

*Work Address

Work Suite/Apartment Number

*Work City

*Work State

*Work Postal Code

*Work Phone

*Work Email

*Amount ($USD)

Payment frequency

One-time

Semi-annually

Annually

*Purpose of Donation

Program Donation

General Donation

Restricted Donation, please indicate purpose

Comment