Swag Shop Registration

Swag Shop Registration Form

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Your Organization

Your Organization Name(Required)

Which profit level are you selecting?(Required)

What Organization should Worx donate to?(Required)

What is the name of the other Organization?(Required)

FEIN(Required)

Website

Organization Address(Required)

Street Address Address Line 2 City State ZIP Code

Type of Nonprofit(Required)

501(c)3

Other type of nonprofit

Main Organization Contact(Required)

First Last

Contact's Email(Required)

Contact's Phone(Required)

Accounting Contact

Organization Accounting Contact(Required)

First Last

Accounting Contact's Email(Required)

Accounting Contact's Phone(Required)

Preferred Payment Type(Required)

Check

ACH

Address to send Check(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Bank Name(Required)

Name on Account(Required)

Routing Number(Required)

Account Number(Required)

Any Comments/Questions?