Adopt a High School Senior
Louisiana Red Beans and Rice Foundation
Donor Name
First Name
Last Name
Donor Notes
Company Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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General Donation
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Graduation Supplies
$
350.00
Quantity
1
2
3
4
5
6
7
8
9
10
Supplies / Bookstore Purchase
$
225.00
Quantity
1
2
3
4
5
6
7
8
9
10
College Course Assistance
$
500.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Afterpay
After submitting the form, you will be redirected to Afterpay to complete the payment.
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