Partnership Registration form

Donation Amount (USD)

Full Name

Phone Number

Payment Method

Credit Card

PayPal

Card Number

Expiry Date

CVC

Your donation is secure and encrypted

Organization Details

Organization Name *

Website

Organization Type *

Contact Person

Full Name *

Position/Title *

Email Address *

Phone Number

Partnership Details

Partnership Type (Select all that apply) *

Financial Support Technical Expertise Resource Sharing Volunteer Support Joint Marketing Other

Area of Interest *

Expected Partnership Duration *

Partnership Goals & Expectations

Additional Information

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