ALLOTMENT DONATION

Allotment Donation

First Name

*

Last Name

*

Rank

SSN

*

Email

**

Duty Status

Originating Campaign

Other Installation

*

AER Section

Unit (Optional)

Pledge Amount (per month)

*

Frequency (months)

**

Allotment Start Date (date/time)

*

Auto-Renewal

NoYes

I would like to receive Text Message (SMS) communications from AER

NoYes

Cell Country Code

Cell Phone

*

Portal Created

NoYes

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