Donation Form

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* Mandatory fields

Company/Organization

Company website

Prefix

*First name

*Last name

Suffix

*E-mail

If you are a regular member and are trying to add a corporate membership -- you must add a unique email address.

Primary Phone

*Donation Amount ($USD)

Comment

hOME OF THE RES!

180 Linden Oaks, Suite 100
Rochester, NY 14625

Administrative Director

Jessie Cocquyt
res@frontiernet.net
585-586-8030