Confirmation Thank You

Thank you so much for your donation!

Thank you for submitting your mailing information.

We are looking forward to sending your our appreciation gift as soon as we can!

Thank you for your support, it means everything to us.

Donation Thank You

Donation Thank You

Thank you so much for your donation!

Please send us your name and mailing address
so that we can thank you for your donation and send you an MpBC Stylus Pen

  • Please indicate your pen color preference:
  • This field is for validation purposes and should be left unchanged.

First form

BASIC DEMOGRAPHIC INFORMATION

This section deals with gathering demographic information. Going forward, you will be identified only by your unique ID, and your personal information will be guarded by the Alliance Admins so that we can reach out to you if additional information is required or if helpful information becomes available. Your name or other identifying information will never appear in any survey results or be released to anyone without your consent.