365 Small Business Circle

365 SMALL BUSINESS CIRCLE FORM

Your Information
Select 365 Small Business Circle Level
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Payment Method
Check Donation
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Make checks payable to United Way of South Central Massachutes and mail to: 
176 Main St., Suite 400, Southbridge, MA 01550
Bill Me
$
$
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Credit/Debit Card Donation
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$
After completing this form you will be redirected to our payment page where you will be able to process your transaction in a secured environment. Please be sure to enter the same values that you have entered on this form. Thank you!
Total Annual Contribution
$0
Agreement
My signature below, confirms what I have provided on this form to be accurate.

Thank you for your contribution. United Way of SCM acknowledges no goods or services beyond what is listed is provided to the company. Your gift is tax deductible to the fullest extent of the law. Please keep a copy of this form for your tax records. Consult your tax advisor for more information.

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