2023 Commitment Form
Please fill out this form and click submit.
Information
Name
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Email
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Phone
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Address
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Short-Term Commitment (prior to June 30, 2024)
One-Time Gift
Please Enter Dollar Amount
Installments
Dollar Amount
Frequency
Please select one option.
Weekly
Bi-Weekly
Monthly
Quarterly
For How Many Months?
Please select one option.
7 (Starting Dec)
6 (Starting Jan)
5
4
3
2
1
Total Installment Amount
TOTAL Short-Term
Long-Term Commitment (after July 1, 2024)
One-Time Gift Amount
Please Enter Dollar Amount
Installments
Dollar Amount
Frequency
Please select one option.
Weekly
Bi-Weekly
Monthly
Quarterly
For How Many Months?
Please select one option.
6 Months
12 Months (1 year)
18 Months
24 Months (2 years)
36 Months (3 years)
37+ Months (More than 3 years)
Total Installment Amount
TOTAL Long-Term
TOTAL COMMITMENT
Add Short-Term & Long-Term Totals
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