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Please print , fill out, and send or fax to:

Name:

Billing address of card:

Please charge my credit card: Type (Amex, Visa or Mastercard):
Number:
Expiration date:

for the amount: US$/other (please specify currency):

as a donation to the Giant Thangka Project. I understand that the funds I have given will be given -minus card and bank charges - to Terris Temple and Leslie Nguyen for the Giant Thangka Project.

signature:

date:

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