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COMPLETE THE FORM BELOW AND CLICK ON THE SUBMIT BUTTON
and we will add your organization to our Community Support Program

   You must be a current officer or list the authorizing officer's name and your own. If you are not a current officer, we must confirm this form submission with an officer. In such a case, have your authorized officer call us toll-free at 1-888-562-8964 for confirmation. Thank you.

 Your Organization

 Your Name & Position

 Email Address

 Mailing Address

 City, State & Zip Code

 Your County

 Phone Number

 Officer Name

 Officer Position

 Date

 Federal Tax ID

 Your Organizational Official Purpose Statement

Does Your Organization Have A Web Site?

 Web Site URL

Does Your Organization Receive Support From Tax Dollars?

Is Your Organization Family Friendly and Pro American?


Important:  Please make sure that an authorized officer calls to confirm this form submission if you are completing it and you are NOT an authorized, current officer of your organization.

Toll Free: 1-888-562-8964


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