Fundraising Interest Form

Thank you for your interest in fundraising for Cure SMA. Please fill out this brief form, and we'll contact you shortly to discuss how we can help you make your event successful and meaningful.

  Contact Information

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Name:

 

 

   

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City/State/ZIP:

 

    

 

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Question - Required - What type of event are you interested in hosting for Cure SMA? (Select all that apply)
Please make at least 1 selection from the choices below.

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(Maximum response 255 chars, approx. 5 rows of text)

 


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Question - Required - What is your preferred method of contact?


 
Question - Not Required - What is the best time of day to reach you? (Select all that apply)
Please make between 1 and 3 selections from the choices below.

 

   Please leave this field empty

     

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