A Donation in Honor OR In Memory

Keep Anonymous: Donation Amount:

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DONOR INFORMATION

First Name: Last Name: Email: Phone:

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HONOREE INFORMATION

Dedication Type: To Who: Address: City: State: Zip Code: - Country: Email: Phone: Donation Note:

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Cash or checks can be

mailed directly to

35A Wilson Drive
Sparta, NJ 07871

Please make checks
payable to
Durga Tree International

Include this printable form
to ensure a receipt