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Yes, I would like to help by becoming a supporting member of Easter Seals.

Here is my gift of:

___$50*   ___$25   ___$15   ___$10   ___Other                     *With a donation of $50 or more,

you may receive a Precious Moments gift. Please call the office for details at (765) 855-2482.         

Name: _____________________________________                     

Address: ___________________________________

               ___________________________________

Thank you for your generosity and for helping us to create solutions

and change lives for children and adults with disabilities.