UA-124351614-1
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Gift Amount
$1,000
$500
$250
$100
$50
$25
Type of Donation
One Time Donation
Recurring Donation
Frequency
Monthly
Annually
Contact Information
Title (Mr.)
First Name
Last Name
Company Name
Address
Address 2
City
State/Province
Alabama
Alaska
Alberta
Arizona
Arkansas
Armed Forces Americas
Armed Forces Other
Armed Forces Pacific
British Columbia
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
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Minnesota
Mississippi
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New York
Newfoundland & Labrador
North Carolina
North Dakota
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Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington DC
West Virginia
Wisconsin
Wyoming
Yukon
Zip/Postal Code
Phone
Email
Parish
Holy Name - Beech Grove
Immaculate Heart of Mary - Indianapolis
Christ the King - Indianapolis
St. Joan of Arc - Indianapolis
St. Lawrence - Indianapolis - Lawrence
St. Luke - Indianapolis
St. Matthew the Apostle - Indianapolis
St. Pius X - Indianapolis
St. Simon the Apostle - Indianapolis
St. Thomas Aquinas - Indianapolis
SS. Peter and Paul Cathedral - Indianapolis
Holy Spirit - Indianapolis
Our Lady of Lourdes - Indianapolis
St. Philip Neri - Indianapolis
St. Therese Little Flower - Indianapolis
St. Michael - Greenfield
Nativity Catholic Church - Indianapolis
Sacred Heart Church - Indianapolis
St. Barnabas - Indianapolis
Good Shepherd - Indianapolis
SS. Francis and Clare of Assisi - Greenwood
St. John the Evangelist - Indianapolis
St. Jude - Indianapolis
St. Mark the Evangelist - Indianapolis
St. Roch - Indianapolis
Our Lady of the Greenwood - Indianapolis - Greenwood
St. Christopher - Indianapolis
St. Gabriel the Archangel - Indianapolis
St. Joseph - Indianapolis
St. Monica - Indianapolis
St. Malachy - Indianapolis
Mary Queen of Peace Danville
St. Thomas More - Mooresville
St. Susanna - Plainfield
St. Vincent De Paul - Shelbyville
St. John the Apostle - Bloomington
St. Martin of Tours
St. Agnes - Nashville
St. Patrick -Terre Haute
St. Charles Borremeo- Bloomington
St. Margaret Mary
Holy Rosary Church - Indianapolis
St. Jude -Spencer (Bloomington visit)
St. Ambrose Church - Anderson
Church of the Blessed Sacrament
Holy Spirit at Geist
Our Lady of Grace Church
Our Lady of Mount.Carmel Church
Our Lady of the Lakes Church
Sacred Heart of Jesus Church - Cicero
Sacred Heart Church - Fowler
St. Alphonsus Liguori Church
St. Ambrose Church - Seymour
St. Ann Church -Lafayette
St. Augusta Church
St. Augustine Church
St. Bernard Church
St. Boniface Church - Lafayette
St. Charles Borromeo - Peru
St. Elizabeth Seton Church - Carmel
St. Joan of Arc Church - Kokomo
St. John the Baptist - Osgood
St. John the Baptist - Tipton
St. John Vianney Church
St. Joseph Church - Delphi
St. Joseph Church - Lebanon
St. Lawrence Church - Layfayette
St. Lawrence Church - Muncie
St. Louis de Montfort Church
St. Maria Goretti Church - Westfield
St. Mary Church - Frankfort
St. Mary Church - Muncie
St. Mary Church - Union City
St. Patrick Church - Kokomo
St. Paul Church - Marion
St. Thomas Aquinas Catholic Center
St. Bartholomew Columbus
St. Mary Cathedral - Lafayette
St. Thomas Aquinas West Lafayette
St. Ann - North Vernon
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Expiration Date
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
24
25
26
27
28
29
30
31
32
33
34
Security Code
Billing Address
Same As Above
Address
City
State/Province
Alabama
Alaska
Alberta
Arizona
Arkansas
Armed Forces Americas
Armed Forces Other
Armed Forces Pacific
British Columbia
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland & Labrador
North Carolina
North Dakota
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington DC
West Virginia
Wisconsin
Wyoming
Yukon
Zip/Postal Code
Email
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