Running Bitcoin Challenge BTCPay Info

Thank you for your donation to the Running Bitcoin Challenge, benefiting ALS Network (formerly Golden West Chapter of The ALS Association).
Before you pay below, we might need some basic information! Those items with an * are required, so we can properly acknowledge your gift. Others are completely optional.

1. Contact information
Employment Information
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3.
4. (Maximum response 255 chars, approx. 5 rows of text)
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8. (Maximum response 255 chars, approx. 5 rows of text)
   Please leave this field empty