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Donations - Secure Online Donation Form
Donations - Secure Online Donation Form

Campaign/Fund Information
Campaign/Fund * General Donation
or Select a Different Fund
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Donation Information
Donation Amount *

NOTE:
The minimum donation amount is $10.00
Payment Method * Credit Card
Please note:
APSNA, Inc., Registration No. CH46292, has complied with registration of Chapter 496, Florida Statutes, the Solicitation of Contributions Act. A COPY OF THE OFFICAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL FREE 1-800-435-7352 WITHIN THE STATE OF FLORIDA. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE.
Donor Comments
Donor Information
First Name *
Middle Name
Last Name *
Suffix
Organization
Email *
Address *
Address Cont.
City/Town *
Country *
State
Postal Code*
Phone *
Billing Information
[ Click here if billing address is the same as donor address ]
 *  
Organization 
Address *
Address Cont.
City/Town *
Country *
State
Postal Code*
Billing Phone *
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