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When you give a to a non-guard NPC from one of the major cities of your faction (excluding Exodar and Silvermoon), you gain a Gift of Adoration and the debuff. A guard NPC will give a which is has the same effects, but has a different name and item id. You cannot gain another Gift of Adoration or until the Adored debuff ends.
You cannot get the pledges nor gifts of the other faction, since you cannot talk to the NPCs.
There are 6 separate Gift of Adoration items, depending on the source city:
Has a chance to contain: