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Donor Contact Information

First and Last Name

Address

City

State/Prov

Zip/Postal

Phone Number

Email Address

Gift Membership

First and Last Name

Address

City

State/Prov

Zip/Postal

Phone Number

Email Address

First and Last Name

Is This a One-Time or a Monthly Sustaining Donation?

Sustaining Monthly Credit Card Donation (You will be directed to a secure site for credit card processing)
One-time Credit Card Donation (You will be directed to a secure site for credit card processing)
Charge on my bank account monthly

By checking this box I acknowledge that KET will debit my bank account each month until I instruct them to stop.

Please Choose Your Donation Amount

All gifts of $60 or more include Visions magazine and KET Passport

$ 60.00
$ 120.00
$ 360.00
$ 600.00
$ 1,200.00
Other Amount

Please specify amount:

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