Annies House at BWP request Form

Thank you for your interest in supporting Annie's House at BWP in Bottineau North Dakota.

I heard about Annies House at BWP through:

A friend Internet Mail News PaperTelevision Work Facebook

Other(please specify)

I would like more information by:

MailEmailOffice StaffNYSTY (New York Says Thank You Organization)

Direct by Board Member Economic Development Corp.

Comment:

Yes

I would like to donate to help make this Dream come true:

As soon as possible Within 1 week Within 2 weeks Within 1 month No

Will you tell us who are you representing

Yes

Would you like to or be able to volunteer

No Yes Maybe

Your Name

Business Name (if applicable)

Address 1st Line

City

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Email address:

Phone number

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Where is it best to contact you?

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What is the best time to contact you?

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Thank you for completing this request We will contact you within three days!

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