HBCU Donations

2. Name*

3. Email Address*

5. Address*

6. Student's Name*

8. City*

9. State*

10. Zip Code*

12. Phone Number*

13. Emergency Contact*

14. Emergency Contact Number*

16. Please choose all that apply*

    1. Donation

17. Enter Amount Here*

19. Quantity

20. Shipping Cost

22. Taxable

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24. Calculate Totals Proceed to Checkout

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