SHE4MECampaignRegistrationForm

Complete this form to join the SHE4ME Campaign

All fields are required.

Your Organization name

Contact name

City

Country

Phone Number

Your email address

Confirm email address

Facebook Page Address

Website

Funds will be sent to your organization through Paypal. Please provide the email address and name for your Paypal account.

Confirm Paypal email address

Paypal first name

Paypal last name

Upload your logo: Minimum of 600 x 600 pixels.

Select a file: Max size = 3MB - Type = .jpg, .png, or .gif

Add your message to your supporters. Store text must not exceed 1,000 characters.

By submitting this form you agree to the campaign terms currently listed on the SHE4ME Campaign website.