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1
Full Name
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First Name
Last Name
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2
Phone Number
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Area Code
Phone Number
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3
Email
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example@example.com
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4
Are you a member of Fervent Church
*
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YES
NO
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5
What items are you looking to donate?
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** We are currently not accepting any clothing donations at this time **
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6
What's your availability to meet with someone at our facilities?
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