DELTA Inc. Consent/Information Release Form
This form seeks permission to contact individuals for purposes of delivering information, soliciting support, donations and volunteers to assist in carrying out the mission of DELTA Inc.
DELTA Inc. Mission
The Developmental Enhancement Life and Training Alliance Incorporated (DELTA Inc.), is a 501(c)(3) non-profit organization that serves the community’s youth and senior citizens Our mission is to provide opportunities for young people to improve the quality of their lives through tutoring, counseling, and support programs that develop a desire for lifelong pursuit of worthy personal goals and to develop an outreach program enriching the lives of senior citizens by providing diversified activities and information pertinent to their well-being and to endeavor to utilize the skills of the senior citizens to enhance the lives of others.
Name
First Name
Last Name
Email
example@example.com
Home Phone Number
-
Area Code
Phone Number
Cell Phone Number
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Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
*
I authorize and grant permission to DELTA Inc. to contact me by mail, phone, text or email.
I will support DELTA Inc. financially but do not wish to be contacted.
I will volunteer to help DELTA Inc. on committees that support its mission.
I grant DELTA Inc. permission to use my photo from events in media and print materials.
I do not wish to receive mail, emails, texts or phone calls from DELTA Inc.
Signature
Date Signed
*
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Month
-
Day
Year
Date
Submit
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