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Please complete this form to make your donation to
Partners for Quality Foundation
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YOUR GIFT
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1. Area of Greatest Need
2. Allegheny Children's Initiative
3. Citizen Care
4. Exceptional Adventures
5. Milestone
6. Partners For Quality Foundation
-other-
Matching Gift Company
Company that will match your gift.
YOUR INFORMATION
Title
Congressman
District Justice
Dr.
Dr. and Mrs.
Governor
Honorable
Miss
Mr.
Mr. and Mrs.
Mrs.
Ms.
Rabbi
Representative
Senator
Sister
*
First Name
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Last Name
Name Suffix
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Address Line 1
Address Line 2
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City
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Country
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-other-
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-other-
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IS THIS DONATION IN HONOR OR MEMORY OF SOMEONE?
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|
NO
Title
Congressman
District Justice
Dr.
Dr. and Mrs.
Governor
Honorable
Miss
Mr.
Mr. and Mrs.
Mrs.
Ms.
Rabbi
Representative
Senator
Sister
First Name
Last Name
Name Suffix
Donor Notes
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