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Fax or Mail Form

If You Prefer to Order by Phone:

Please have the following information ready:

#1 The item you wish to order (PLEASE STATE: "This is an ADAA donation order"):

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#2 Your mailing information, including:

1. Your Full Name (as it appears on credit card)
2. Address
3. City
4. State
5. Zip Code
6. Phone number

#3 Shipping address if different from your mailing address

#4 And your payment information

1. Credit card type (Visa or Master Card) Name on the card
2. Credit Card number Expiration Date

Call Now toll-free 1-800-394-2299 (or toll: 919-942-0700)

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