BAMM Program Registration Form

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* 1. Please select your registration type:

Retailer

Church/Faith Community Partner

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* 2. Full Name

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* 3. Email Address

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* 4. Phone Number

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* 5. Business/Organization Address

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* 6. Name of Business/Organization

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* 7. Website (if applicable)

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* 8. Please describe your business/organization

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* 9. What types of support are you interested in? (Select all that apply)

Marketing Support

Financial Assistance

Networking Opportunities

Workshops and Training

Other

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* 10. If you selected 'Other' in the previous question, please specify

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* 11. Why are you interested in the BAMM program?