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Scholarship Information
Donate to the NEWVMA Scholarship Fund
Donate to the NEWVMA Scholarship Fund
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Donation
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Mandatory fields
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First Name
*
Last Name
Business or Clinic Name
Enter your business, clinic or hospital name. Otherwise enter 'Retired' or 'N/A'
Contact Information
*
E-Mail Address
Business Phone Number
Name of individual or business donating
*
Amount ($USD)
Benefactor Level ($5000+)
$5,000.00 (USD)
Platinum Level ($1000-4999)
$1,000.00 (USD)
Gold Level ($500-999)
$500.00 (USD)
Silver Level ($100-499)
$100.00 (USD)
Bronze Level ($10-99)
$10.00 (USD)
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