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Please use following form to prepare your donation on line. A member of the Foundation staff will contact you to complete your donation.
If you prefer to mail your donation to us, please download this form.

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Type of Donation  
I want to make a single gift of:*
I want to make a monthly gift of:

Totaling:
Minimum total gift $60.00 or $5.00 per month. We will charge your card each month from the date of your initial gift.

to benefit:*
Fund:*
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the following program:
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Donor Information  
  Mr. & Mrs. Mr. Mrs. Ms. Dr.
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My gift is: Anonymous
  If your donation is to be made in honor or memory of someone, please complete the following:
  In Honor of In Memory of
  Name:
   
Send notification to:  
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May we contact you?  
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If you have any questions about this form or would prefer to make a
donation via phone please call us at 802.772.2458.
Please enter these numbers to complete this request.
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