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Registration |
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If you would like to arrange another form of payment for a
Platinum, Gold or Silver Table Sponsorship or Platinum or Gold Ticket, please email us at kristybarnes@inclusionproject.org or call 919-314-5540.
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Please note: The National Inclusion Project does not share or supply personal information
of our donors to anyone for any reason of solicitation or other purposes. For
more details view our
Privacy Policy. |
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BILLING INFORMATION: |
Name (as it appears on your credit card)
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Street Address
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Street Address (cont)
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City
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State
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Zip Code
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Country
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Phone
Your phone number is required in the event it is necessary to contact you concerning
your donation/credit card information. |
Email
You will receive an electronic confirmation of your registration. |
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TABLES AND TICKETS: |
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| If you are puchasing a table enter the number of tables or enter the number of individual tickets to be purchased here:
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(max 9)
All sales are final.
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PAYMENT METHOD: |
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Credit Card Number:
(EX: XXXXXXXXXXXXXXXX) |
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Exp. Date:
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SUBMIT REGISTRATION: |
Please press the submit button only once to ensure proper delivery of your registration.
A Receipt Will Be Sent Upon Credit Card Authorization
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If you would like to mail or fax your donation, or contact us:
National Inclusion Project
104 TW Alexander Dr
Building 1
PO Box 110104
Research Triangle Park, NC 27709
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Phone: 919-314-5540
Fax: 919-314-5541 |
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