Community Partnership- EPIC Box

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* 1. Name of your Business or Organization

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* 2. Contact Name

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* 3. Contact Email Address

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* 4. Contact Phone Number

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* 5. How would you like to connect with Crossroads?

Monetary Donation

Donation of Goods

Information about your company or organization

Volunteering

Other (please specify)

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* 6. Any comment, question, idea or concern