I want to help

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Name:_____________________________________________________________

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Address:___________________________________________________________

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City, State, Zip______________________________________________________

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Donation Amount: __$25  __$50 __$100 __$200 __$500 __$1000 __$1000 __$2000

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Make checks payable to : Friends of Skeele for Assembly

Send to:
Friends of Skeele for Assembly
c/o Shawn Skeele
262 East Lake Rd.
DeRuyter, NY 13052

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