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This form will act as your pledge to help us raise funds during your birthday week, however little the amount. After submission, You will receive an email later on with all the details and a guide on what your post on social media should look like. 

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* 1. Full Name

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* 2. Job Title

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* 3. Birthday (Day and Month) 

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* 4. Preferred social media platform to use

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* 5. Email Address

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* 6. Phone Number (+254 format)

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* 7. How did you learn about this initiative? (tick appropriately)

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