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Tribute of Light Ceremony Volunteer Form
Contact Name
*
Address
*
City
*
State
*
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Alabama
Alaska
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District of Columbia
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Northern Marianas Islands
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Puerto Rico
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Tennessee
Texas
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Vermont
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Virgin Islands
Washington
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Wisconsin
Wyoming
Zip
*
Daytime Phone
*
Evening Phone
Email Address
*
Number of Adults in Your Party
*
Number of Children in Your Party
*
Volunteer Names
*
Please list the names of all volunteers below.
Have You Purchased a glowing tribute from ACS?
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Yes
No
If yes, would you like to carry this glowing tributein the ceremony?
*
Yes
No
If yes, what is/are the name(s) of the individual(s) for whom you purchased a glowing tribute?
*
Please note: If you do not specify a name prior to November 10th, we cannot guarantee that you will carry the candle that you purchased in the ceremony. You may be given an alternate name to carry.
*
Indicates a required field
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