Template:2012FR/Form-countryspecific-MG5000

Donation amount (USD)

• Just Once
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• $5000
• $7500
• $10000
• $12500

• $15000
• $17500
• $20000
• Other

Please select an amount (minimum $1)

We cannot accept donations greater than USD $4 ($1 $2) through our website. Please contact our major gifts staff at $3.

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