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<h2 class="gform_title">Contact Donor Ministries</h2>
<span class='gform_description'>If you would like for a member of the Donor Ministries Team to contact you, please fill out the form below.</span>
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<label for='input_377_11_1' id='input_377_11_1_label' >Street Address</label>
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<label for='input_377_11_2' id='input_377_11_2_label' >Address Line 2</label>
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<label for='input_377_11_3' id='input_377_11_3_label' >City</label>
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<input type='text' name='input_11.4' id='input_377_11_4' value='' aria-required='false' />
<label for='input_377_11_4' id='input_377_11_4_label' >State / Province / Region</label>
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<input type='text' name='input_11.5' id='input_377_11_5' value='' aria-required='false' />
<label for='input_377_11_5' id='input_377_11_5_label' >ZIP / Postal Code</label>
</span><span class='ginput_right address_country ginput_address_country' id='input_377_11_6_container' >
<select name='input_11.6' id='input_377_11_6' aria-required='false' ><option value='' selected='selected'></option><option value='US' >United States</option><option value='AF' >Afghanistan</option><option value='AL' >Albania</option><option value='DZ' >Algeria</option><option value='AD' >Andorra</option><option value='AO' >Angola</option><option value='AI' >Anguilla</option><option value='AQ' >Antarctica</option><option value='AG' >Antigua and Barbuda</option><option value='AR' >Argentina</option><option value='AM' >Armenia</option><option value='AW' >Aruba</option><option value='AU' >Australia</option><option value='AT' >Austria</option><option value='AZ' >Azerbaijan</option><option value='BS' >Bahamas</option><option value='BH' >Bahrain</option><option value='BD' >Bangladesh</option><option value='BB' >Barbados</option><option value='BY' >Belarus</option><option value='BE' >Belgium</option><option value='BZ' >Belize</option><option value='BJ' >Benin</option><option value='BM' >Bermuda</option><option value='BT' >Bhutan</option><option value='BO' >Bolivia</option><option value='BA' >Bosnia and Herzegovina</option><option value='BW' >Botswana</option><option value='BV' >Bouvet Island</option><option value='BR' >Brazil</option><option value='IO' >British Indian Ocean Territory</option><option value='BN' >Brunei Darussalam</option><option value='BG' >Bulgaria</option><option value='BF' >Burkina Faso</option><option value='BI' >Burundi</option><option value='KH' >Cambodia</option><option value='CM' >Cameroon</option><option value='CA' >Canada</option><option value='CV' >Cape Verde</option><option value='KY' >Cayman Islands</option><option value='CF' >Central African Republic</option><option value='TD' >Chad</option><option value='CL' >Chile</option><option value='CN' >China</option><option value='CX' >Christmas Island</option><option value='CC' >Cocos (Keeling) Islands</option><option value='CO' >Colombia</option><option value='KM' >Comoros</option><option value='CG' >Congo</option><option value='CD' >Congo, The Democratic Republic of The</option><option value='CK' >Cook Islands</option><option value='CR' >Costa Rica</option><option value='CI' >Cote D'ivoire</option><option value='HR' >Croatia</option><option value='CY' >Cyprus</option><option value='CZ' >Czech Republic</option><option value='DK' >Denmark</option><option value='DJ' >Djibouti</option><option value='DM' >Dominica</option><option value='DO' >Dominican Republic</option><option value='EC' >Ecuador</option><option value='EG' >Egypt</option><option value='SV' >El Salvador</option><option value='GQ' >Equatorial Guinea</option><option value='ER' >Eritrea</option><option value='EE' >Estonia</option><option value='ET' >Ethiopia</option><option value='FK' >Falkland Islands (Malvinas)</option><option value='FO' >Faroe Islands</option><option value='FJ' >Fiji</option><option value='FI' >Finland</option><option value='FR' >France</option><option value='GF' >French Guiana</option><option value='FM' >French Metropolitan</option><option value='PF' >French Polynesia</option><option value='TF' >French Southern Territories</option><option value='GA' >Gabon</option><option value='GM' >Gambia</option><option value='GE' >Georgia</option><option value='DE' >Germany</option><option value='GH' >Ghana</option><option value='GI' >Gibraltar</option><option value='GR' >Greece</option><option value='GL' >Greenland</option><option value='GD' >Grenada</option><option value='GP' >Guadeloupe</option><option value='GT' >Guatemala</option><option value='GN' >Guinea</option><option value='GW' >Guinea-bissau</option><option value='GY' >Guyana</option><option value='HT' >Haiti</option><option value='HM' >Heard Island and Mcdonald Islands</option><option value='HN' >Honduras</option><option value='HK' >Hong Kong</option><option value='HU' >Hungary</option><option value='IS' >Iceland</option><option value='IN' >India</option><option value='ID' >Indonesia</option><option value='IR' >Iran, Islamic Republic of</option><option value='IQ' >Iraq</option><option value='IE' >Ireland</option><option value='IL' >Israel</option><option value='IT' >Italy</option><option value='JM' >Jamaica</option><option value='JP' >Japan</option><option value='JO' >Jordan</option><option value='KZ' >Kazakhstan</option><option value='KE' >Kenya</option><option value='KI' >Kiribati</option><option value='KR' >Korea, Republic of</option><option value='KW' >Kuwait</option><option value='KG' >Kyrgyzstan</option><option value='LA' >Lao People's Democratic Republic</option><option value='LV' >Latvia</option><option value='LB' >Lebanon</option><option value='LS' >Lesotho</option><option value='LR' >Liberia</option><option value='LY' >Libyan Arab Jamahiriya</option><option value='LI' >Liechtenstein</option><option value='LT' >Lithuania</option><option value='LU' >Luxembourg</option><option value='MO' >Macao</option><option value='MK' >Macedonia</option><option value='MG' >Madagascar</option><option value='MW' >Malawi</option><option value='MY' >Malaysia</option><option value='MV' >Maldives</option><option value='ML' >Mali</option><option value='MT' >Malta</option><option value='MQ' >Martinique</option><option value='MR' >Mauritania</option><option value='MU' >Mauritius</option><option value='YT' >Mayotte</option><option value='MX' >Mexico</option><option value='MD' >Moldova, Republic of</option><option value='MC' >Monaco</option><option value='MN' >Mongolia</option><option value='MS' >Montserrat</option><option value='MA' >Morocco</option><option value='MZ' >Mozambique</option><option value='MM' >Myanmar</option><option value='NA' >Namibia</option><option value='NR' >Nauru</option><option value='NP' >Nepal</option><option value='NL' >Netherlands</option><option value='AN' >Netherlands Antilles</option><option value='NC' >New Caledonia</option><option value='NZ' >New Zealand</option><option value='NI' >Nicaragua</option><option value='NE' >Niger</option><option value='NG' >Nigeria</option><option value='NU' >Niue</option><option value='NF' >Norfolk Island</option><option value='NO' >Norway</option><option value='OM' >Oman</option><option value='PK' >Pakistan</option><option value='PA' >Panama</option><option value='PG' >Papua New Guinea</option><option value='PY' >Paraguay</option><option value='PE' >Peru</option><option value='PH' >Philippines</option><option value='PN' >Pitcairn</option><option value='PL' >Poland</option><option value='PT' >Portugal</option><option value='QA' >Qatar</option><option value='RE' >Reunion</option><option value='RO' >Romania</option><option value='RU' >Russian Federation</option><option value='RW' >Rwanda</option><option value='SH' >Saint Helena</option><option value='KN' >Saint Kitts and Nevis</option><option value='LC' >Saint Lucia</option><option value='PM' >Saint Pierre and Miquelon</option><option value='VC' >Saint Vincent and The Grenadines</option><option value='WS' >Samoa</option><option value='SM' >San Marino</option><option value='ST' >Sao Tome and Principe</option><option value='SA' >Saudi Arabia</option><option value='SN' >Senegal</option><option value='SC' >Seychelles</option><option value='SL' >Sierra Leone</option><option value='SG' >Singapore</option><option value='SK' >Slovakia</option><option value='SI' >Slovenia</option><option value='SO' >Somalia</option><option value='ZA' >South Africa</option><option value='ES' >Spain</option><option value='LK' >Sri Lanka</option><option value='SD' >Sudan</option><option value='SR' >Suriname</option><option value='SJ' >Svalbard and Jan Mayen</option><option value='SZ' >Swaziland</option><option value='SE' >Sweden</option><option value='CH' >Switzerland</option><option value='SY' >Syrian Arab Republic</option><option value='TW' >Taiwan, Province of China</option><option value='TJ' >Tajikistan</option><option value='TZ' >Tanzania, United Republic of</option><option value='TH' >Thailand</option><option 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<label for='input_377_11_6' id='input_377_11_6_label' >Country</label>
</span>
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