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Donator's Name: _______________________________ Phone No. ___________________ Email: ____________________________ Grotto Affiliation (if any) __________________ Date of donation: ___________ Amount of donation: __________ Check: _____ Cash: ____ ---------------------------------------------------------------------------------------------------------- This portion to be completed by UAYCEF Board member and returned to Donator: Date Received: _______________ Donation received by: ___________________________ Receipient's Signature: _________________________ Amount : ______________________ |
ver. 4/25/00