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Please Print, Fill In and Mail this Donation
Form Along with your Cheque or Money Order to:
Loads Of Love
76 Sandys St.
Chatham, ON
N7L 4Y5
Amount: $_________
Designation of Funds: ___________________________
Donated by:
Name:___________________________ Phone (____) ____________
Address:_______________________________
City:_______________________________
Province:___________________________
Postal Code:________________________
Donor Signature_______________________Date_____________
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