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I would like to help VMC address the health issues facing our community. Name (first, middle initial, last) Address City, State, Zip Day Phone Evening Phone Email J My check is enclosed payable to
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It is a form that is used to indicate the desire or intention of the person filling it out.
Anyone who wants to express their desire or intention.
You can fill it out by stating clearly and concisely what you would like to do or achieve.
The purpose is to communicate your desires or intentions.
You must report what you would like to do or achieve.
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