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I/we wish to donate, or pledge, $____________to the ____________________ Fund.
This donation is in memory of ________________________________
Name _____________________________________________________________________
Address ___________________________________________________________________
Phone _______________________ Date____________________
Please send this form to:
Newark-Arcadia
Historical Society
P.O. Box 289
Newark, NY 14513
Checks payable to Arcadia Historical Society
Thank your very much for your support. All donations are tax deductible.