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Radical Women 2022 Spring Fundraiser
Donation Form
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Email
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Your email
Date Donation Received
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MM
/
DD
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YYYY
First and Last Name
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Your answer
Business Name (if required)
Your answer
Street Mailing Address
Your answer
City
Your answer
State
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Zip Code
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Phone:
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Email:
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Affiliation
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Member of KLMBA
Friend of KLMBA
Unknown
Donation Public?
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Yes
No
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Donation Made Via
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Cash
Check
CashApp
Givelify
Debit/Credit Card (submit below)
To give with a debit or credit card click here:
https://giv.li/s3q7ak
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District Donation
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District 1 and District 2
District 1
District 2
District 3
District 4
District 5
Unknown/No District preference
Wall of Honor OR Circle of Influence
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Wall of Honor ($199 or less)
Circle of Influence ($200 or more)
Title of Woman
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Sister (If no preference listed)
Mother
Reverend
Missionary
Deacon
Deaconess
Lady
Pastor
In Honor Of: First & Last Name
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Your answer
From:
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Message/Church (ONLY Circle of Influence $200 or more) NO MORE THAN 40 Characters)
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Notes?
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