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Please use it for _________________________, or r where most needed.
Your Name: _______________________________________Your Company/Organization: _______________________________________Street Address: _______________________________________City/State/Zip: _______________________________________Phone Number: _______________________________________Email Address: _______________________________________
Check or Credit Card Information
Name on Card: _____________________________________________Card Type: _____________________________________________Account Number: _____________________________________________Expiration Date: _____________________________________________
and Mail to:Volunteers of America, DakotasAttn: Marty GallanterPO Box 89306Sioux Falls, SD 57109-9306Fax to:Volunteers of America, DakotasAttn: Web Donations605-335-5514 (Only fax credit card donations)