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Name *
Address, City, State, Zip *
E-Mail *
Phone Number
Media Release: Yes, I give you permission to have my name and photograph released to the public media (Enter your name below). *
What did it mean to receive a Midwest Mission Kit? *
How helpful was this kit?
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How did you use this kit? *
Are there any unique stories of recipients?
Tell us about your organization? *
Who are you serving?
What are your goals?
If you have any pictures please email them to Ashley Earles Communications Manager at:
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