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* 1. Name of Organization

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* 2. Charitable or Not for Profit #

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* 3. Contact Name, Phone, and Email

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* 4. Community

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* 5. If your group is chosen as a Fuel Good Day recipient, what would your group use the funds for?

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* 6. When restrictions relating to COVID-19 are removed, how many of your group members can you provide to help out at Fuel Good Day?

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