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JDRF logoBest of Illinois 2009
JDRF Illinois
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2009 Best of Illinois Dinner


I would like to make a donation in honor of Glen Tullman.
dollars
(amount of donation)

Donations of $3,500 and above will be listed in the program book. Please specify how you would like your listing to appear.
Deadline for all listings is May 4, 2009.

(your name)
Donations of $5,000 or more will receive an ad in the commemorative book. Please see the ad specs for details. Deadline for all ads is May 4, 2009.

Person Who Asked You to Purchase Tickets or Donate:


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Billing Information
Cardholder's Name:
This address MUST match your credit card billing address
Billing Address 1:
Billing Address 2:
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State:
Zip Code:
Cardholder's Main Phone: () -  Extension:
Your E-mail Address:

Additional Information
Home Phone: () - (If different from main phone)
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with Diabetes:
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Other (Please specify):
Please Send me: JDRF's Newsletter
Additional Information about JDRF Illinois




If you would like an alternate way to give please call 312/670-0313.

JDRF Illinois
500 North Dearborn, Suite 305
Chicago, Illinois 60654-3387

JDRF is an accredited 501(c)(3) nonprofit agency; all donations (including membership donations) are tax deductible.



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