Ukrainian Refugee Relief

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Donor Information First Name: Last Name: Address: Address 2: City: State/Province: Zip/Postal: Country: Phone: Email:

Payment Information Card Number: Expiration:
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Donation Type One time contribution of:

$

Monthly contribution of:

$ for months

Comment or Designation

Please send your check to:

Orthodox Church in America
PO Box 31409
Alexandria, VA 22310-9998

Be sure to include a note clearly indicating any designations.

All gifts are tax deductible.

Thank you!