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Gateway Pregnancy Centers

30 th. Annual Stewardship Banquet

Souvenir Journal Response Form


Please return this form to Gateway with full payment
----------------------- CUT HERE --------------------Ad copy or attach artwork (black and white only)

___________________________________________
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Name: _______________________________________________________________________
Business name: ________________________________________________________________
Address: _____________________________________________________________________
City: ______________________________________State:_________Zip:_________________
Phone: (
)___________________ Ad size desired: _____________________
Total amount enclosed: $ ______________
I am unable to place an ad but please accept my gift of $______________

Gateway Pregnancy Centers, Inc.


PO Box 1793, Union, NJ 07083
(973) 399-8378

E-mail: dean@gateway.org

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