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Your donation ensures that every child who walks through our door gets unconditional support and comprehensive care.

Your Gift

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Would you like to make your gift in honor or memory of someone?

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Optional message to include

Is your company matching your gift?

Yes

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First Name *

Last Name *

Email *

Phone *

Address *

City *

State *

ZIP *

Billing and Payment

Billing information same as above

First Name *

Last Name *

Address *

City *

State *

ZIP *

I'd like to cover the processing fee so 100% of my donation goes to The Valerie Fund.

Payment Options

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1. Credit Card

Card Number *

CVV *

Expiration: Month/Year *

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Donate

Your Gift

How would you like to donate?

How much would you like to give?

Would you like to make your gift in honor or memory of someone?

Full Name of Honoree*

Event Name (optional)

Recipient Name *

Address *

City *

State *

ZIP *

Optional message to include

Is your company matching your gift?

Company Name:

First Name:

Last Name:

Address:

Phone:

Email:

About You

Title *

First Name *

Last Name *

Email *

Phone *

Address *

City *

State *

ZIP *

Billing and Payment

First Name *

Last Name *

Address *

City *

State *

ZIP *

Payment Options

1. Credit Card

Card Number *

CVV *

Expiration: Month/Year *

2. Apple Pay

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