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Please print out the form below and send it with your check.

TEANECK VOLUNTEER AMBULANCE CORPS
PO Box 32, Teaneck, NJ 07666-0032
$100 $75 $50 $36* $25 Other: ______
*$36.00 = A donation of less that 10 cents per day

Name: ____________________
Address:___________________
__________________________
__________________________

THANK YOU. YOUR SUPPORT IS APPRECIATED.

 


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