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Your name or the name of your company
If applicable
What would you like to name your fund
Why are you starting a fund
EX: Fund for Military families, cancer victims, only in certain counties, anyone going through a medical crisis,etc...
Such as money and/or gift certificate for staple items
Let the applicant and possible donors know the story of your fund
The benefits of opening up a medical fund
Committee Job Description- Check box indicating you understand.
Type your name in the below. ( Signature will be obtained when approved)
Date of signature
If applies