| Name | Jacob Bast |
|---|---|
| Email hidden; Javascript is required. | |
| SEP or SEH | SEP |
| SEP Locations | Administration |
| SEP Groups / Departments | Virtual Health Center |
| SEH Groups / Departments | – Fill Out Other Fields – |
| Donation Type | Financial Donation |
| Financial Donation Amount | Other Amount |
| Credit Card Fees | $45.00 |
| Payment Method | PayPal Checkout |
| Enter Other Amount | $1,500.00 |
| Would like to pay the Credit Card Fees? | Yes |
| Total Donation | $1,545.00 |
| Payment Information | |
| Select Method of Payment | PayPal/Venmo |