Request for COOKIE DOUGH Use
This is the same information that I need to submit to council.   Please have the full card number, expiration, and CVV ready before proceeding. 
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Email *
Is the scout paying just for herself or also for someone else like a parent?  If so, please add the extra names(s) here.  Put in the total amount requested down below.
Scout's First Name: *
Scout's Last Name: *
Street Address: *
City: *
Zip Code: *
Parent/guardian Email:
Card Number: *
Card Expiration Date: *
Card CCV: *
Amount:  It can be for full or partial payment. *
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