Minnesota Keystone Application Renewal
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Please choose from one of the following:
I want to renew giving 2% pre-tax earnings to the community
I want to renew giving 5% pre-tax earnings to the community
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Company Name
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Have your address changed since your last renewal? If yes, please fill out the new address.
Yes
No
Address
City, State, Zip Code
Contact Information
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CEO/ Primary Contact
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Title
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CEO/ Primary Phone Number
Fax Number
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Email
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Communication Contact
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Title
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Communication Phone Number
Fax Number
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Email
Contribution to the Minnesota Keystone Program
If you would like to make a voluntary contribution to the Minnesota Keystone Program to help offset the program and operating costs, you may do so by indicating your contribution below.
Our company would like to make a contribution to the Minnesota Keystone Program.
Amount (Suggested amount is $150. Please make checks payable to the MRCC Development Foundation.)
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Indicates Response Required
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