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Name*

First Last

Donation Amount*

Full Campership - $4,100

2 Full Camperships - $8,200

3 Full Camperships - $12,300

1 Week Partial Campership - $1,596

1 Day Partial Campership - $228

Other Amount

Other Amount*

Total

Credit Card*

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MasterCard

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Expiration Date

Security Code Cardholder Name

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone

Sweeney de Mayo Donation