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Contact Information
Full Name
Date of Birth
Email
Phone
Street Address
City
School
In 250 Words or Less, Describe Your Business. Please Include the Business Name
How Much Funding Are You Looking For? (Up to $5000)
Tell Us a Little About What You'll Use This Money For, and Who, If Anyone, Is Supporting Your Business
If You Are Under 18, Please Include a Parent or Guardian's Email Address
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