SSA Blue & Gold Fund Online Donation Form

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Donation Information
Amount:	Founder's Society $ 1,883.00 $ 1,250.00 $ 500.00 $ 250.00 $ 100.00 $ 50.00 Other $     *
Additional Information
Frequency:	Weekly Monthly Quarterly Annually On:   Sunday Monday Tuesday Wednesday Thursday Friday Saturday Starting:    Ending:   Ending:
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Designation:	Financial Aid Faculty Support Arts Athletics Buildings & Grounds Library Science and Technology Boarding Unrestricted	*
Billing Information
Title:	1st Lt. Admiral Ambassador Attorney Brig. General Brother Capt. Captain Cmdr. Col. Colonel Commander Dean Detective Director Dr. Drs. ENS Ensign Father General Governor Hon. Honorable Judge L.Cpl. Lieutenant Lord Lt. Lt. Cmdr Lt. Col Ret. Lt. Col. LTC LTJG M. Madam Maj. Major Master Mayor Miss Mme Mr. Mrs. Ms. Pastor Prof. Profs. Pvt. Rabbi Rector (Ret.) Rev. Rev. Canon Rev. Dr. Rev. Father Reverend Right Rev. Senator Sgt. Sir Sir/Madam Sister Spc. The Hon. The Honorable The Rev. The Reverend Secretary Cpt.
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Country:	ALBANIA ARGENTINA AUSTRALIA AUSTRIA BAHRAIN BELGIUM BRAZIL BULGARIA CAMBODIA CAMEROON CANADA CHILE CHINA, P.R. COSTA RICA COTE D'IVOIRE CROATIA CZECH REPUBLIC DENMARK DOMINICAN REPUBLIC EGYPT ENGLAND FRANCE GERMANY GHANA GUATEMALA HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN IRELAND ISRAEL ITALY JAMAICA JAPAN KENYA KUWAIT LAOS MEXICO MONGOLIA NAURU NETHERLAND ANTILLES NETHERLANDS NEW ZEALAND NIGERIA NORWAY PAKISTAN PANAMA PHILIPPINES POLAND PUERTO RICO REPUBLIC OF KOREA ROMANIA RUSSIAN FEDERATION SAUDI ARABIA SINGAPORE SLOVAKIA SPAIN SWEDEN SWITZERLAND TAIWAN R.O.C. THAILAND TRINIDAD AND TOBAGO TURKEY UGANDA UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES VENEZUELA YUGOSLAVIA	*
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Card Expiration:	01 02 03 04 05 06 07 08 09 10 11 12  / 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033	*
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