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Donation

* Mandatory fields
*First name
*Last name
Nickname
Organization
Occupation
*Email
Phone
*Birthday
Joined
*Address
*City
*State
*Zip Code
Past President Year
Fill in year that you were president
Lifetime_Achievement
Outstanding_Beaver
Current_Board
Children Name
Please input children name and age on each line
Spouse Name
Military Service & Rank
Highschool and Graduation Year
College
College name, field of study and graduation year each line
Other Organizations
List all other organizations you belong
Sponsoring Members
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*Amount ($USD)
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"Beaver Club of Lafayette Inc" is a 501(c)3 non-profit organization. P.O. Box 2774, Lafayette, LA 70502

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