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Send form with your check or credit card information to:

Scleroderma Foundation
Attn: Donations
300 Rosewood Drive Suite 105
Danvers, MA 01923

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I would like to Become a Member and help support the Scleroderma Foundation's efforts to improve the lives of those with scleroderma, and to assist in the search for a cause and cure. Enclosed please find my check (or credit card information) in the amount of $___________ (first $25 goes towards membership).

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Reason for donation (check one): My donation is a tribute to someone special.
     
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My donation is a memorial to someone special.

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Please notify: _________________________________ of my donation.

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I don't want to become a member; I only want to donate.

300 Rosewood Drive, Suite 105, Danvers, MA 01923 · Phone 978-463-5843 · 800-722-HOPE (4673)
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