Fundraising / Revenue Share Account Registration

     

    Account Registration establishes your authorized account and allows you to view enrollments, generated revenue, and payments made to you by Emergency Contact Data. It also provides access to your marketing materials.

     

    • ORGANIZATION NAME*

    • ADMIN FIRST NAME*

    • ADMIN LAST NAME*

    • ADMIN TITLE*

    • ADMIN EMAIL*

    • VERIFY ADMIN EMAIL*

    • PASSWORD*

    • VERIFY PASSWORD*

    • Enter between 8 to 11 characters with at least one of each of the following: number, upper & lower case letter, plus any of these special characters $ ! @

    • NONPROFIT 

      YES

    •   My organization has completed a signed-agreement governing the distribution of the Emergency Contact Data Service.

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    • ADDRESS 1*

    • ADDRESS 2 

    • CITY*

    • ST/PROV*

    • ZIP/CODE*

    • COUNTRY*

    • PRIMARY PHONE*

            

    •   EXT. 

        

    • ALTERNATE PHONE 

            

    •   EXT. 

        

    • FAX 

            

    • INT’L DIALING CODE*

    • COMMENT: 

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