Thank you for helping to make college dreams come true!

Please use this form to check out for the evening.  If you need assistance or prefer another way to make payment please let us know, we would be happy to accommodate. 

Heads or Tails - how many people played? ($50/play)
Heads or Tails - How many times did you buy back in? ($25/per)
Thank you for raising your paddle, what amount did you raise your paddle for?

Donor Information

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Credit Card Information
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Visa®, MasterCard® & Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.

Cover the fee associated with this online transaction?
Cover the fee associated with this online transaction?
Your total payment will be
Your credit balance will cover
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