Charity Name
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Charitable registration number (i.e. 119075505RR0001):
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Address:
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City:
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Postal Code:
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Contact Name:
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Contact Title:
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Contact Email:
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Contact Phone:
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How many teens (aged 13-18) does your organization serve?
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Please briefly explain how your organization supports at-risk youth:
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PASS USE AGREEMENT
I agree to donate any/all passes donated by the PNE to the teens served by the charity ONLY.
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I understand that passes are not to be sold, exchanged, or used for any other purposes.
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I understand misuse of passes will result in loss of eligibility for any future pass distributions.
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