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Name/Organization requesting a donation:
Name
Organization
Email
Phone
Address
City/Town
State/Province
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Alabama
Alaska
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Arizona
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Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
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California
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Connecticut
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District of Columbia
Federated States of Micronesia
Florida
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Hawaii
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Indiana
Iowa
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Louisiana
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Maryland
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Amount of requested donation:
Amount of requested donation:
Amount of requested donation:
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What is the purpose of your organization?
Please provide a detailed description of the donation request including goals and objectives.
How will the money be spent and who will be the administrative contact?
Please share how this donation will make life better in our communities; and approximately how many people will this affect?
Please upload any document you would like to include to support your request.
One file only.
20 MB limit.
Allowed types: txt, pdf, doc, docx, ppt, pptx, odp, xls, xlsx, ods.
Please upload any image you would like to include to support your request.
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Allowed types: gif, jpg, png, svg.
