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Order Candles for the

Memories Matter Fundraiser

* - Required Field

First Name*
Last Name*
Email Address*
How many candles would you like to purchase?
Each candle is $30.
Total:  
Notes
Total Payment Amount
Description and ID
Street Address (for billing purposes)*
City*
State*
Zip Code*
Credit Card Info
*
*
Credit Card Expiration Date*
*
(Located on the back of the card)