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(Please print this form and return by mail to MWC)

How you can help

1. DONATE MEDICAL SUPPLIES
AND EQUIPMENT
2. CHILD FOCUS:
DONATE DRY INFANT FORMULA
3. DONATE MEDICINE
4. DONATE YOUR TIME

YOUR DOLLAR IS WORTH THE MOST
Thank you for ACTING NOW.

Name:____________________________________________________________________________

Address: _________________________________________________________________________

City: ________________________________________________State:_____ Zip:______________

Email: _________________________________________

Phone: __________________ Fax: _________________

I would like to donate: ( )$25 ( )$50 ( )$100 ( )$500 Other: _______

Please make checks payable to: Muslim Women’s Coalition

Send this form to 1283 Rte 27, Somerset, NJ 08873

 


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