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SUSTAINER- Credit/Debit Card
SUSTAINER- Monthly withdrawls from bank account

By checking here, you agree to allow IPR/Ball State PBS to withdraw your monthly contribution from your bank account. Monthly contributions will be made until you instruct IPR to stop.

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Recipient Information

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ResidenceBusiness

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Remaining Characters: 120120

Recipient Information

Recipient First Name(s)

Recipient Last Name

Same as donor

ResidenceBusiness

Address Line 1

Address Line 2 (Apt, Floor, Suite, etc.)

City

State/Prov

Zip/Postal

Recipient Telephone

Extension

Recipient Email

Delivery Date

Message

Remaining Characters: 120120

Recipient Information

Recipient First Name(s)

Recipient Last Name

Same as donor

ResidenceBusiness

Address Line 1

Address Line 2 (Apt, Floor, Suite, etc.)

City

State/Prov

Zip/Postal

Recipient Telephone

Extension

Recipient Email

Delivery Date

Message

Remaining Characters: 120120

Recipient Information

Recipient First Name(s)

Recipient Last Name

Same as donor

ResidenceBusiness

Address Line 1

Address Line 2 (Apt, Floor, Suite, etc.)

City

State/Prov

Zip/Postal

Recipient Telephone

Extension

Recipient Email

Delivery Date

Message

Remaining Characters: 120120

Recipient Information

Recipient First Name(s)

Recipient Last Name

Same as donor

ResidenceBusiness

Address Line 1

Address Line 2 (Apt, Floor, Suite, etc.)

City

State/Prov

Zip/Postal

Recipient Telephone

Extension

Recipient Email

Delivery Date

Message

Remaining Characters: 120120

Recipient Information

Recipient First Name(s)

Recipient Last Name

Same as donor

ResidenceBusiness

Address Line 1

Address Line 2 (Apt, Floor, Suite, etc.)

City

State/Prov

Zip/Postal

Recipient Telephone

Extension

Recipient Email

Delivery Date

Message

Remaining Characters: 120120

Recipient Information

Recipient First Name(s)

Recipient Last Name

Same as donor

ResidenceBusiness

Address Line 1

Address Line 2 (Apt, Floor, Suite, etc.)

City

State/Prov

Zip/Postal

Recipient Telephone

Extension

Recipient Email

Delivery Date

Message

Remaining Characters: 120120

Recipient Information

Recipient First Name(s)

Recipient Last Name

Same as donor

ResidenceBusiness

Address Line 1

Address Line 2 (Apt, Floor, Suite, etc.)

City

State/Prov

Zip/Postal

Recipient Telephone

Extension

Recipient Email

Delivery Date

Message

Remaining Characters: 120120

Recipient Information

Recipient First Name(s)

Recipient Last Name

Same as donor

ResidenceBusiness

Address Line 1

Address Line 2 (Apt, Floor, Suite, etc.)

City

State/Prov

Zip/Postal

Recipient Telephone

Extension

Recipient Email

Delivery Date

Message

Remaining Characters: 120120

Recipient Information

Recipient First Name(s)

Recipient Last Name

Same as donor

ResidenceBusiness

Address Line 1

Address Line 2 (Apt, Floor, Suite, etc.)

City

State/Prov

Zip/Postal

Recipient Telephone

Extension

Recipient Email

Delivery Date

Message

Remaining Characters: 120120

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