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Casa Pacifica Kid's Club Donation Information
Our esteemed Casa Pacifica Kid's Club member's annual contribution makes it possible for Casa Pacifica to maintain services for children and young adults struggling with mental health disorders in Ventura and Santa Barbara Counties.
Amount:
$ 30,000.00
$ 20,000.00
$ 15,000.00
$ 10,000.00
$ 5,000.00
$ 2,500.00
$ 1,500.00
Other
$
*
Additional Information
Frequency:
Weekly
Monthly
Quarterly
Annually
On:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Starting:
Ending:
Ending:
Corporate:
This donation is on behalf of a company
Please type your name exactly as you want it to appear in publications:
Billing Information
Title:
Dr.
Mr.
Mrs.
Ms.
Rabbi
Reverend
First name:
*
Middle name:
Last name:
*
Country:
United States
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*
Address lines:
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City:
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State:
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*
ZIP:
*
Phone:
*
Email:
*
Payment Information
Cardholder's Name:
*
Credit Card Number:
*
Card Type:
American Express
Discover
MasterCard
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*
Card Expiration:
01
02
03
04
05
06
07
08
09
10
11
12
/
2023
2024
2025
2026
2027
2028
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2037
2038
2039
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2042
*
Card Security Code:
*
Matching Gifts
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Company:
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