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Business Affiliation Form - Formulário de Afiliação para Empresas
Please fill out the form below. Automatic monthly payments may be selected by clicking on Recurring Payment and selecting the monthly amount. Please fill in the amount of the donation you wish to acquire:
Água Marinha $50/monthly - $480 annually
Turmalina $100/monthly - $960 annually
Esmeralda $250/monthly - $2,400 annually
Favor preencher o formulário abaixo. Caso necessite da tradução para o português é só clicar no Ponto de Interrogação (?). Você poderá optar por pagamentos mensais automáticos clicando em Recurring Payments. Favor preencher o valor da afiliação que escolher:
Água Marinha $50/mês - $480 anual
Turmalina $100/mês - $960 anual
Esmeralda $250/mês - $2,400 anual
Organization
*
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$
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Name
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First Name
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Last Name
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Address
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Address Line 1
Address Line 2
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City
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State
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Zip
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$
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Job Title
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Email
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Phone
*
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A donation amount must be chosen before continuing.
$
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One Time
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Select your Affiliation
*
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Água Marinha - $50/mo - $480/yr
Turmalina $100/mo - $960/yr
Esmeralda $250/mo - $2,400.yr
Please choose one of the above options to continue.
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A donation amount must be chosen before continuing.
$
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One Time
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Donation
*
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A donation amount must be chosen before continuing.
$
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One Time
Recurring
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$10
Agua Marinha $50/monthly - $480/yearly
BRONZE $10
Esmeralda $250/monthly - $2,400 Annually
OURO | GOLD $50
PRATA | SILVER $20
Turmalina $100/month - $960/yearly
Note
*
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A donation amount must be chosen before continuing.
$
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One Time
Recurring
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You may choose to contribute 2.2% to cover the processing fee