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1 of 2

Hartford Memorial Marathon Dance

Donation Form (Bring this with you to the dance)

Name	Phone Number	Donated Amount	Received(Cash/Check/ Online)
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$	TOTAL

Dancer/Student Name:

2 of 2

Hartford Memorial Marathon Dance

Donation Form (Bring this with you to the dance)

Name	Phone Number	Donated Amount	Received(Cash/Check/ Online)
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$
		$	TOTAL