| The American Cancer Society

American Cancer Society - The Official Sponsor of Birthdays.™

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How much would you like to give?

I'll add $0.00 to cover service, processing fees, and other expenses to ensure the cause receives more of my contribution.

I'll add $0.00 to cover service, processing fees, and other expenses to ensure the cause receives more of my contribution.

$21.00 will be charged to your account on the 15th of every month (until you ask us to stop).

Would you like to make this gift in honor or in memory of someone?

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YES

What type of tribute?

IN HONOR
IN MEMORY

Make a gift in honor of:

Make a gift in memory of:

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SAMPLE CARD

You'll be able to send an ecard or a paper card after you complete your donation.

The system requires you to finish the card sending process within 15 minutes, so be sure to have email or postal addresses handy.

Your contact information

First Name *

Last Name *

E-Mail *

Phone #

Address *

Address 2

Zip / Postal Code *

City *

State / Province *

Country *

Yes, send me e-mail updates on how my gift is making a difference.

Would you like your Employer to match the gift?

If so, please enter your Employer Name below:

Employer

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