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Contact Details    
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Position  
Phone (Office Hours)  
Email  

Organisation Details    
Charity/Organisation Name:  
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Website Details    
Expected number of web site visitors (monthly):  

0-100
100-1000
1000-10,000
10,000+

     
What is/will your website be used for?   Organisation News / Upcoming events
Mailing List
Accepting Donations
Providing information / Support
Selling Products / Distribution

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