Thank You

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WE APPRECIATE YOUR GENEROSITY

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DONOR INFORMATION

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Name: {Name (First):6.3} {Name (Last):6.6}
Email: {Email:8}
Phone: {Phone:10}
Organization: {Organization:12}
Website: {Website:11}
Address: {Address (Street Address):7.1} {Address (Address Line 2):7.2} | {Address (City):7.3}, {Address (State / Province):7.4} {Address (ZIP / Postal Code):7.5}

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DONATION INFORMATION

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Donation Id: {Donation ID:1}
Donation Amount: {Donation Amount:19} {Other Amount:21}
Are You Supporting A Rider? {Are You Supporting A Rider?:22}  {Alexandra\’s Angel Rider’s Name:23} {Enter Angel Rider\’s Name:14}
In Honor/Memory Of: {In Honor/Memory Of:13}
Credit Card: {Credit Card (Card Type):2.4}
Credit Card Number: {Credit Card (Card Number):2.1}

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Meet Rider #1 – Alexandra

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Checks may be mailed to:
Alexandra’s Angels MS Foundation, Inc.
1500 North Federal Highway #200
Fort Lauderdale, Florida 33304

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[email protected]

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954-566-1234

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