Yes, I will become a monthly donor! I
will help advance the human rights of people living with, at risk
of, or affected by HIV.
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My Information
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Email
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First Name
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Last Name
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Street
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City
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Country
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Province
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Postal Code
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Phone (Day)
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My Monthly Gift
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Frequency:
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Contribution Amount:
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You can easily change or cancel your gift at any time by contacting
us directly.
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My Payment
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Cardholder Name:
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Credit Card #:
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Security Code (CVV2):
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Card Type:
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Expiry:
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Do we have your permission?
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We are always interested in knowing who our donors are, and your reason for giving. Please feel free to share with us, or give us other feedback.
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Thank you so much for supporting the human rights of people
living with HIV!
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Recurring message
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