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"Our Supporters" Web Page
Modification Request Form

     You can use this form for a variety of reasons including:

  • You are not listed on the Our Supporters web page, but gave a donation and wish to be listed and have your membership upgraded from a free member to a paid member.
  • You are already listed, but want to modify the listing.
  • You are listed, but want to change to an anonymous listing.
  • You don't want to be listed, but want to be upgraded from a free member to a paid member

 

Your Name:
 
Company:
 
Street Address:
 
City, State, Zip:
 
Telephone:
 
Web address:
 
E-Mail:
 
  (Required fields are listed in bold)

Description of modification requested:
(Note: if you are making a request to be listed or have your
membership upgraded from a free membership to a paid membership,
please include the amount and approximate date of your donation.)

                              


If you have any questions or need further assistance, you can call us at
425-771-4049 or e-mail us at assistance@thecampaign.org