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Questionnaire

What is your FIRST and LAST name?

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Best Contact: Email or Phone

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What type of items will you be collecting? You may choose more than one category

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I will turn my donations in on:

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Would you like additional flyers, handouts, donation bin, and/or informational materials for your drive?

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If you are a local business, religious organization, group, or club - please atttach your logo for us to publish on our social media!

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