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Donate to the Double Angel Foundation
    

Name _____________________________________________________________
Address 1 _____________________________________________________________
Address 2 _____________________________________________________________
City _____________________________________________________________
State _____________________________________________________________
Zip Code _____________________________________________________________
Daytime Phone _____________________________________________________________
Email _____________________________________________________________
Mailing List
 Yes, please put me on e-mail list    
No, thank you
Payment Method
American Express

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Master Card

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Amount
$25    
$50   
$75   
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$150   
$250    
$500   
Other $______
Credit Card # _____________________________________________________________
Expiration Date _____________________________________________________________
Signature _____________________________________________________________
Please Print, then Fax or Mail to:


The Double Angel Foundation
P.O. Box 4004
Parker, CO 80134
Fax: 303-841-5557