MEMBERSHIP / SUPPORTER INTAKE FORM

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MEMBERSHIP / SUPPORTER INTAKE FORM

10000 Strong > MEMBERSHIP / SUPPORTER INTAKE FORM

MEMBERSHIP / SUPPORTER INTAKE FORM

(501(c)(3) Safe)

Name:(Required)

Email:(Required)

Phone:(Required)

City / State:

Select Monthly Support Level:(Required)

Statement of Alignment:(Required)

Briefly share why you are supporting the 10,000 STRONG program.

Acknowledgment (Required):(Required)

I understand my contribution is a charitable donation

I understand assistance is not guaranteed

I acknowledge this program is operated by Freedom Foundation Inc.

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Date

MM slash DD slash YYYY

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10,000 STRONG is a program of Freedom Foundation Inc., a 501(c)(3) nonprofit organization. EIN: 84-2897233. Assistance is not guaranteed and is subject to review, eligibility, and availability of charitable funds. This program does not provide insurance or contractual benefits.

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MEMBERSHIP / SUPPORTER INTAKE FORM

MEMBERSHIP / SUPPORTER INTAKE FORM

(501(c)(3) Safe)

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