DONORS
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Donor's Information
First Name:
Jordan
Last Name:
Palma
Gender:
Male
Date of Birth:
11/29/1990
Address:
861 Eastern
City:
Grand Rapids
Zip Code:
49503
Email:
jordan.palma19@yahoo.com
Phone:
(616)987-7654
Edit
Do you have any disabilities or other conditions that would prevent you from performing activities in connection with volunteer services?
If yes, please explain.
Have you been convicted of a misdemenor or felony within the past seven(7) years?
If yes, please identify the conviction, or the pending charge. Identify state, county, and court.