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Membership Demographics

Some of the grants that we are applying for require information about our demographics. Please Fill out the following information about yourself. We will use this information solely for fundraising.

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your street address?

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* 4. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 5. What is your preferred email?

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* 6. What is your phone number?

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* 7. How do you prefer to receive information? Our goal is to deliver information to you in the format you prefer and to not overwhelm you.

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* 8. If you chose direct mail, email, or phone call, how often would you want to receive contact?

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