Organization and Contact Information

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Questions? Contact Mandy Niesen at 904-389-3622 ext. 302 or email mandy@jacksonvillemag.com.

* 1. Organization Name

* 2. Address

* 3. City

* 4. State

* 5. ZIP

* 6. Phone Number

* 7. Short Description of Organization

* 8. Email

* 9. Select One

* 10. User Info: Name

* 11. User Info: Email

* 12. User Info: Phone Number

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