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COVID-19 SUPPORT DRIVE - Application
You, or a group you're associated with, needs help during this time, and we hope we can be of some assistance to you! Please fill out the form below to help us understand your needs.
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Name of company, nonprofit, school, etc. (if applicable)
Your answer
Website (if there is one)
Your answer
Physical Address (if applicable)
Your answer
Your name
*
Your answer
Your role
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Your email address
*
Your answer
Your phone number
*
Your answer
Describe what you are in need of, or the help that you are seeking:
*
Your answer
Tell us a little about you or the company, nonprofit, school, etc, that you're associated with:
Your answer
How did you hear about Impact's Covid-19 Support Drive?
*
Your answer
Anything else you would like to tell us?
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Please hit SUBMIT, and we will be in touch with you shortly! Thank you!
If you have questions, please email us at: Info@ImpactIn.app
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