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* 1. What is your charitable organisation name

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* 2. Main contact

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* 3. Email

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* 4. Phone Number

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* 5. Do you have a mission statement? If so please detail below

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* 6. Briefly tell us how a Dynamic Earth Golden Ticket would benefit your organisation.

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* 7. Number of full time employees / volunteers working for your organisation

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* 8. Main geographic area covered

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