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Donation

* Mandatory fields
*First name
Middle Name
*Last name
*Email
Phone
*Address
*City
*State
*Zip
Organization
*Membership Level
Please choose one
*Preferred Method of Contact
Society Interests
*Amount ($USD)
Comment
 Payment frequency
Donation in honor of:
Please note the name of the person being honored with your donation
Honoree address and email
Please list honoree's address and email so your donation can be acknowledged
Donation in memory of:
Please note the person you are remembering.
In-Kind Donation
In-Kind Donation Amount
In-Kind Donation Description
Describe the type in in-kind donation
*BHS acknowledgment of your donation on website