FORWARD Pledge Card

Your name *

Last name

Email address *

Address

HomeWorkOther

Country

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Phone number

Phone type

MobileHomeWorkOther

NEW: I would like to make a new commitment to the FORWARD campaign of:

INCREASE: I would like to increase my original commitment to the FORWARD campaign of:

AFFIRM: I would like to affirm my original commitment to the FORWARD campaign

Please count my gift today of _____ towards my commitment.

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