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YES! I WANT TO HELP CAPITAL DISTRICT CENTER FOR INDEPENDENCE, INC. PROMOTE INDEPENDENT LIVING FOR PEOPLE WITH DISABILITIES

Please click here to read our Mission Statement.

(printable form)

Name: ___________________________________

Address: _________________________________

City: ____________________________________

State: _________ Zip: ______________________

Phone: __________________________________

E-mail: __________________________________

Please Print Clearly

Enclosed is my gift of $ ______________

Please mail completed form to:

Capital District Center for Independence, Inc.,
845 Central Ave., South 3,
Albany, NY 12206

Please be reminded your gift is tax deductible up to the extent permitted by NYS and Federal Laws. A receipt will be mailed to you for your records.

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