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Postal Mail Order Form 03 03 ... 03 Print this page and send your donation to The Life Center P.O. Box 2174 Winnetka, CA 91396 . Make your check or money order payable to The Life Center If you send cash, we cannot guarantee its safety during delivery. Mail to: The Life Center P.O. Box 2174 Winnetka, CA 91396 Please print Clearly Your Name:_______________________________________________ Mailing Address:___________________________________________ City:_____________________ State:__________ Zip:___________ E-mail Address: __________________________________________ Phone Number: ___________________________________________ Whom do you know that we should contact regarding our work? Their Name:______________________________________________ Mailing Address: __________________________________________ City:_____________________ State:___________ Zip:__________ Their E-mail Address: ______________________________________ Can we say that you referred them to us _____ YES _____ NO. . Please share your thoughts and opinions with us. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ . |