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This is the form to mail in for your contribution for the furnace. Just mail it with your donation.

 Name: ________________________________

 Address: _________________________________________

 City: _________________________

 Postal code/zip: _____________________

 Phone Number: __________________

 Donation: $__________

Church of Epiphany congregation would like to thank-you for your generosity for your donation.   
Mail your donation to the following address:

Church of Epiphany
11 Briscoe ST. W
 London, Ontario
         N6J 1L9