| Join The Friends of the MWMS Clinic, Inc. Please mail this completed form along with your Tax Deductible contribution to: Friends of the MetroWest MS Clinic 152 Moore Road Sudbury, MA 01776 |
First Name: ________________________________ Last Name: ________________________________ Street Address: ___________________________________________________ City: _________________________ State: __________ Zip: _______________ Phone Number: (optional) ______________________________ Donation Amount (suggested fee is $5.00): ________________________ Please make checks payable to Friends of the MetroWest MS Clinic. |
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| Thank you for your support! |