Donate Your Day!
First, thank you so much for donating your day to Disability EmpowHer Network! Whether it’s your birthday or the anniversary of your disability, we know this day is important to you and it means so much to us that you would share your special day with us!

Please fill out the form below so we can contact you as your day approaches & help you to set up a fundraiser!
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Email *
Name *
Do you want to donate your birthday or disability anniversary? *
When is your special day? *
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DD
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YYYY
Is there anything else you'd like to share?
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