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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
Discover
Master Card
Visa
Amount $25    $50   $75   $100   $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: 303.805.1823