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DonorName:
EMail:
Address:
Phone:
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IamdelightedtohelpsupportCampAZDAbycontributingthefollowinggift(s):
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Enclosedisacheckfor__________________________________________________
Pleasechargemycreditcardforthisamount:$_______________________________
cc#:______________________________________expirationdate:_____________
nameoncard:_________________________________________________________
signature:____________________________________________________________
IllarrangefordeliveryofmyinkinddonationwiththeADA.Pleasecontactmeat
(phoneoremailaddress):________________________________________________
GiftReceivedby:__________________
Date:_________________
TheAmericanDiabetesAssociationisa501(c)(3)taxexemptorganization.
Donationsaretaxdeductibletotheextentpermittedbylaw.
TaxID131623888.Forquestions,contactjgarcia@diabetes.org
Donationsmaybesentto:
AmericanDiabetesAssociation
CampAZDA
5333N.7thStreetSuiteB212
Phoenix,AZ85014.