Submitted By:
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Organization
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Contact Method
*
Contact Address / Phone
Event Name
*
Date(s)
(Start / End)
*
Town / State
*
Event Internet Link
*
Is this an Annual Event?
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Yes
No
Is this a Fundraising Event?
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Yes
No
Event Beneficiary
Offer a Discount?
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Yes
No
If Yes, what is the Discount?
Security Code
*