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1
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One-time gift
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Solliciteur
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Le Chaînon
Madeleine Rousseau
Louise Rousseau
Other
Gift type
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Individual donation
One-time donation amount
$
2
Personal information
E-mail
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Personal E-mail
Professional E-mail
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Personal
Corporate
Title
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Mr.
Mrs.
Ms.
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Abbot
Brother
Deacon
Director
Doctor
Father
Honourable
Miss
Monsignor
Pastor
Professor
Reverend father
Reverend mother
Sister
Gender
First name
Last name
Job title
Company
Country
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Canada
France
United States
Phone
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Home
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Cellular
Additional information
If you are a returning donor, have you moved since your last donation
Yes
Non
To which of the following age groups do you belong
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18-30
31.40
41-50
51-60
60 and more
3
Payment
TOTAL amount
$0
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SIREN
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Organization's registration number:
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