CCM EXAM SCHOLARSHIP

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Goal {{formatAmount(campaignStats.goalMeter.goalAmount)}}

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Raised

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Donors

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Registrants

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RAISED OF {{formatAmount(campaignStats.goalMeter.goalAmount)}}

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{{campaignStats.goalMeter.registrantCount}} Registrant{{campaignStats.goalMeter.registrantCount > 1 ? 's':''}}

CCM EXAM SCHOLARSHIP OPPORTUNITY

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1

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$25 Donation = 1 entry

$50 Donation = 3 entries

$150 Donation = 10 entries

2

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3

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DONATE TO ENTER

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Other Amount

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USD

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Campaign

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How did you hear of this scholarship? *

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Secure Payment

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First Name *

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Last Name *

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Email *

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Phone *

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Address Line 1

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Address Line 2

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City

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State/Province

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Zip/Postal Code

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Country

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Secure Payment

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Card

ACH

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or enter your card details below

Cardholder First Name *

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Cardholder Last Name *

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Cardholder Email

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Card *

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Billing address is the same as mailing address

Address Line 1

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Address Line 2

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City

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State/Province

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Zip *

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Country

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Amount:

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Secure Payment

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Password:

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Email:

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ACH Payment Confirmation

Verify that your bank account information is accurate.

Total Amount

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Routing Number

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Bank Account Type

{{Number(formData.payment.ach.accountType) === 2? 'Checking' : 'Saving'}}

Bank Account Number

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ACH payments may take up to 10 days to appear on your bank account statement.