IMGN Life
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2025 Baby Bottle Campaign
Your Support
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Your Amount
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Total
Donation Amount
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This donation is being made on behalf of a company/organization.
Company Name
Company Phone
Company Email
Prefix
Prefix
Atty.
Bishop
Chaplain
Col.
Congressman
Dr.
Father
First Lady
MGYSGT
Minister
Miss
Mr.
Mrs.
Ms.
Pastor
Prof.
Rev.
Sister
Very Rev.
First Name
Last Name
Suffix
Suffix
Esq.
II
III
Jr.
PhD
Sr.
V.F.
Email
Confirm Email
Phone
Phone Type
Phone Type
Work Cell
Work
Other
Mobile
Home
Fax
Cell 2
Cell
Chaplain
Church Main
Church-FB#
Direct
DISCONNECTED
Emergency #
Husband-Cell
On Website
Pastor Cell
Pastor Home
Pastor Wife Work
Pastor Work
Unknown
Wife-Cell
Street Address
Apt, Suite, Bldg.
City
State/Province/Region
Zip/Postal Code
Country
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Exp. Year
Year
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
CVV Number
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Additional Information
Church
10008 Southpoint Pkwy, Suite 105, Fredericksburg, VA 22407, United States
https://imgnlife.org/
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