SpecialBlessings_GiftOrderForm

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Gift Order Form CONTACT Name Address City State Zip E-mail

METHOD OF PAYMENT CHECKLIST: Card Number Exp. Date Total: Signature Check Enclosed

SEND TO: ICC PO BOX 8056 Silver Spring, MD 20907

Amount $

small stuffed animal kid-sized clothes, pajamas and socks comb or hairbrush toothbrush (not toothpaste) completed gift order form $7 donation for overseas shipping


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