Pennies in Action Donor Information

Pennies in Action® - Benefiting Dr. Brian Czerniecki's Breast Cancer Vaccine Research
	Enclosed is my tax-deductible contribution of $
	My Gift is in Memory/Honor of:
Name
Address
Address
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email
	Please make your check payable to: Pennies in Action Mail your donation to: Pennies in Action c/o IceWorks Skating Complex 3100 Dutton Mill Road Aston, PA 19014 attn: Uschi Keszler
	Your donation is fully tax deductible. Pennies in Action is a registered 501(c)(3) organization.
	An electronic Letter of Acknowledgement will be sent to you using the information above.
	Would you like your donation to be anonymous? yes no
	Pennies in Action qualifies for Corporate Matches - please check with your company to see if they have a Matching Gift program for employee donations.