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May 14, 2024
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Partnership Interest Form

First Name*

Last Name*

Designation(s)

Title*

Organization/Company*

Address

Address Line 2

City

State

Zip Code

Work Phone

Cell Phone

Website

Partnership Interest*

Cash Donation

In-Kind Donation

Overview of Offer*

Value of Partnership Offer

(Please provide dollar amount.)

MPINCC greatly appreciates any and all partnership offers and will work with you to maximize your investment in the chapter.

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