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Friends of Conexión
Please fill out your contact information so we can thank you for your contribution and we can update you on Conexión Projects. Not all of the questions are required. ¡Gracias!
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* Indicates required question
Name for Mailing
Ex: Mr. & Mrs. Pablo Gomez / Ms. Ann Smith / Mr. Paul Jones & Mr. Pedro Lopez
Your answer
First Name(s)
*
Ex. John or John & Heidi (if married or domestic partners)
Your answer
Last Name
*
choose one if more than one per household
Your answer
Street Address
*
123 Main St.
Your answer
City
*
Your answer
State
MI
Other:
Clear selection
Zip
*
Your answer
Phone #
Your answer
Email
*
Your answer
Donation Amount for 2015 per household
(Please provide what you are willing to provide in this tax year.)
$25
$50
$100
$250 Corporate Sponsorship
$500 Corporate Sponsorship
Other:
Clear selection
Possible Donation Amount for 2016?
(you are in no way obligated - this will help us to budget for next year)
$50
$100
$250
$500 Corporate Sponsorship
Other:
Clear selection
Would you be willing to volunteer for a Conexion event in the future?
Yes
No
Other:
Clear selection
Would you be interested in traveling with Conexion?
Yes
No
Other:
Clear selection
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