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Please complete and submit the form below to make a donation to the National Council on Alcoholism and Drug Dependence-Rochester Area.

Name*
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Address*
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I/We wish our donation to remain anonymous
- Please make our donation anonymous
Memorial and Honor Gifts
If you are contributing a gift in memory or honor of someone and would like NCADD-RA to send acknowledgement to the family, please enter their information below.
Name of person gift is being made in memory/honor of:
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Please send the acknowledgement to:
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Comments/Special Instructions
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Donation Amount*
Total
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NCADD Rochester