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Get *Donor Name *Street Address *City *Email Address *State Mobile Phone *Zip - Hthwalks

CIARY INFORMATION AND DONATION AMOUNT List Beneficiary Organizations you are supporting and donation amount: *1. *$ 2. $ 3. $ 4. $ 5. $ *Total Amount Donated: $ PAYMENT METHOD (CASH IS NOT ACCEPTED) Check/money order Visa MasterCard Credit Card number: I authorize the amount of $ Cardholder Name: (Make checks/money orders payable to: Help the Homeless/CFNCR.) Total Amount of check: $ Discover American Express Expiration Date: to be charged to my credit card. Signature: Mail t.

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