Major Larry J. Bauguess Jr. Memorial Fund

Please Print

Your Name:_______________________________

Mailing Address: ( necessary for tax deductible receipt)

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e-mail address for updates on fund progress: ____________________________

Amount of Donation: (checks only please)______________

Date:____________________________________

Any Comments/Rememberances to share:

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Please Mail to:

Maj. Larry J. Bauguess, Jr. Memorial Committee

PO Box 2568

North Wilkesboro, NC 28659