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Organization Winners Registration

Organization (Charity) Information

Organization Country *

United States
United Kingdom
Canada
The Caribbean

Are you a new or existing organization? *

Existing
New

Organization Name *

Contact Person *

Email *

Phone *

New Organization Address:

USA Address *

Address Line 1

City

State

Zip Code

International Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Click On The Number Of Winners You Are Submitting? *

1
2
3
4
5
6
7
8

Winner #1

Winner #1 - Country *

United States
United Kingdom
Canada
The Caribbean

Winner #1 - Certificate # *

Winner #1 - Name *

First

Last

Winner #1 - Email *

Winner #1 - Phone *

Winner #1 - USA Address *

Address Line 1

City

State

Zip Code

Winner #1 - International Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Winner #2

Winner #2 - Country *

United States
United Kingdom
Canada
The Caribbean

Winner #2 - Certificate # *

Winner #2 - Name *

First

Last

Winner #2 - Email *

Winner #2 - Phone *

Winner #2 - USA Address *

Address Line 1

City

State

Zip Code

Winner #2 - International Address *

Address Line 1

City

State

Zip Code

Winner #3

Winner #3 - Country *

United States
United Kingdom
Canada
The Caribbean

Winner #3 - Certificate # *

Winner #3 - Name *

First

Last

Winner #3 - Email *

Winner #3 - Phone *

Winner #3 - USA Address *

Address Line 1

City

State

Zip Code

Winner #3 - International Address *

Address Line 1

City

State

Zip Code

Winner #4

Winner #4 - Country *

United States
United Kingdom
Canada
The Caribbean

Winner #4 - Certificate # *

Winner #4 - Name *

First

Last

Winner #4 - Email *

Winner #4 - Phone *

Winner #4 - USA Address *

Address Line 1

City

State

Zip Code

Winner #4 - International Address *

Address Line 1

City

State

Zip Code

Winner #5

Winner #5 - Country *

United States
United Kingdom
Canada
The Caribbean

Winner #5 - Certificate # *

Winner #5 - Name *

First

Last

Winner #5 - Email *

Winner #5 - Phone *

Winner #5 - USA Address *

Address Line 1

City

State

Zip Code

Winner #5 - International Address *

Address Line 1

City

State

Zip Code

Winner #6

Winner #6 - Country *

United States
United Kingdom
Canada
The Caribbean

Winner #6 - Certificate # *

Winner #6 - Name *

First

Last

Winner #6 - Email *

Winner #6 - Phone *

Winner #6 - USA Address *

Address Line 1

City

State

Zip Code

Winner #6 - International Address *

Address Line 1

City

State

Zip Code

Winner #7

Winner #7 - Country *

United States
United Kingdom
Canada
The Caribbean

Winner #7 - Certificate # *

Winner #7 - Name *

First

Last

Winner #7 - Email *

Winner #7 - Phone *

Winner #7 - USA Address *

Address Line 1

City

State

Zip Code

Winner #7 - International Address *

Address Line 1

City

State

Zip Code

Winner #8

Winner #8 - Country *

United States
United Kingdom
Canada
The Caribbean

Winner #8 - Certificate # *

Winner #8 - Name *

First

Last

Winner #8 - Email *

Winner #8 - Phone *

Winner #8 - USA Address *

Address Line 1

City

State

Zip Code

Winner #8 - International Address *

Address Line 1

City

State

Zip Code

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