Make A Difference (Part 2, Story)
(Please Be Honest In Filling Out The Form)
By Filling Out This Form You Promise To Use This Reward To Make A Difference In Someone's Life
One Third Can Be Used For Family
One Third Can Be Used For Friends
One Third Can Be Used For Strangers
Who did you make a difference for?
*
Please Select
Family
Friend
Stranger
Name
*
First Name
Last Name
Email
*
example@example.com
What is YOUR Membership ID Number
*
How would you like to receive your reward?
*
Please Select
Paypal
Venmo
Coinbase
Gcash
Enter Your Valid and Verified Gcash Number
*
Paypal Email
*
Venmo Username or Email
*
Coinbase Email
*
Tell your story of what you did with the initial reward (who you gave it to, why you gave it to them, etc.)
*
Please upload a picture of you making a difference in their life with the reward
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload a selfie (Smiling is best)
*
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of
Please upload a family picture
Browse Files
Drag and drop files here
Choose a file
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of
By Providing Information, You Agree To Allow The Foundation To Use Your Name and Likeness On Leaderboards, Internet and Social Media
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Should be Empty: