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World March of Women

http://www.worldmarchofwomen.org/
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Support us financially - form

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Fill out the form below, choose the amount you wish to send us and the method of payment.



First Name :
Surname :
Address :
City :
Province :
Country :
Postal code :
Telephone at home :
Telephone at work :
Fax :
E-mail address @ :

Here is my donation:         EURO       US dollars

50$         100$         175$         $ other
I am making my donation by

Cheque (enclosed)
Please make your cheque out to World March of Women



THANK YOU FOR YOUR SUPPORT!

To print the form, click on the Print icon on the tool bar of your Web browser.

Tool :
Universal Currency Converter

Please attach your cheque to this form and send to the following address :

World March of Women
Rua Ministro Costa e Silva, n º 36
Pinheiros, São Paulo- SP -BRAZIL
05417-080
PHONE : +55 11 3032-3243
FAX : +55 11 3032- 3239
@ : info@marchemondiale.org


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Last modified 2008-02-25 01:24 PM
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