Patron - Jason Fleming

Date/Time

All checks and money orders should be made payable to 100 Black Men of Indianapolis.

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First Name

Last Name

Beau Email*

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Patron Information

Patron or Business Name*

First Name

Last Name

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Patron Donation Amount* $

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Credit Card Processing Fee

Total Donation Amount $

A 3.25% processing fee will be added to all Credit Card transactions

Credit Card

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Matching Gift Amount $