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| First Name* | Last Name* | ||
| Organization/Business (if applic.) | Title | ||
| Street Address* | |||
| Address 2 | |||
| City* | State* Zip Code* + 4 | ||
| Work Phone | Home Phone | ||
| Mobile Phone | FAX | ||
| E-mail* | |||
Please apply my donation to the following:
| Sister to Sister Summit |
Amount |
$ | ||
| Crystal Award |
Amount |
$ | ||
| Issues Forums |
Amount |
$ | ||
|
Undesignated |
Amount |
$ | ||
|
TOTAL |
$ Check # |
| Additional Comments: | |
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Enter today's date -- mm/dd/yy |
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| Mail to: | Kathleen Sallee, Treasurer Women's Equity Foundation 946 Devon Circle Maryville, TN 37804 |
Thank you for your donation to the Women's Equity Foundation!