Anna – Fundraising Page

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Name*
First Last
Email*
Phone*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Name
Amount*
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- $100
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- $200
- Other
Other Amount*

If you prefer to donate by check instead, please make out to Wellspring and mail to:

Wellspring 480 Broadway LL 20 Saratoga Springs, NY 12866

Thank you!

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