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Credit Card Check / Mail

Community, Veteran Outreach Area (online payment)

Organization / Company Name

Name

First

Last Name

Last

Address

City

State/Province

Zip/Postal

Email

Phone

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Maximum file size: 50MB

Payment

Community Outreach Registration

To help offset credit card processing costs, you may choose to add a 2.91% ($7.28) fee to your payment.

Total

$250.00

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