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Donation In-take Form
Thank you for donating to our organization! Please fill out this form so we can reach out to you with information to accept a direct donation via bank transfer.
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Email
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Your email
First Name
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Last Name
*
Your answer
Name of Organization/Company
*
N/A if an individual.
Your answer
Phone
*
Your answer
Donation Amount
*
Your answer
How did you hear about us?
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Is there anything else you'd like to share with us?
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