Preferred Phone definition

Preferred Phone. □ Home □ Business □ Cell Preferred Mail: □ Home □ Business Opening Contribution Please indicate the amount and nature of the opening contribution to the Gift Fund (check all that apply). The minimum opening contribution is $10,000 for individuals and families; $50,000 for corporations or other business entities. If making a contribution of multiple securities or assets, please attach additional pages as needed. Additional gifts can be made at any time. Please refer to The Charitable Giving Guide for further information. □ Check, ACH or Wire for $ □ Marketable securities: shares of □ Mutual funds: shares of □ IRA/retirement plan/life insurance (attach a copy of beneficiary designation form) □ Bequest or other deferred gift – If the opening contribution will be made via a bequest or other deferred gift, check the box and complete the Planned Giving section immediately below. □ Other: □ Closely held stock, partnership or LLC interest, etc. – FFTC can accept gifts of closely held business interests via Community Investments Foundation, a Subsidiary Foundation of FFTC. Please contact FFTC staff to discuss a gift of closely held business interests and to request the appropriate documents. □ Real estate – FFTC can accept gifts of real property via Community Real Property Holdings, Inc., a Subsidiary Foundation of FFTC. Please contact FFTC staff to discuss a gift of real property and to request the appropriate documents. Estimated value of total initial contribution(s): Planned Giving If known or reasonably expected, please indicate the amount, nature and timing of future contributions (including any deferred gift) to the Gift Fund, if any. The Foundation can help you and your financial advisors structure a planned gift that meets your philanthropic and financial goals. A planned gift is one that originates during your lifetime but is not available to the Foundation until after your death or some other later event. There is no requirement that a planned gift or additional gift be made to the Gift Fund, but estimates of future contributions, if any, will help the Foundation determine how best to administer the assets of, and grants from, the Gift Fund.

Preferred Phone. □ Home □ Business □ Cell Preferred Email: □ Primary □ Other Choose one level of authority, as defined above: Add Online Fund Access (includes the privilege to recommend grants from the Gift Fund) Add Online Fund Access “View Only” (does not include the privilege to recommend grants) Section continues on the next page. Authorized Party 2 (optional): □ Mr. □ Mrs. □ Ms. □ Other First Name Middle Initial Last Name Preferred Name Title: Street City State Zip Code Phone: Home Work Cell Email: Primary Other

Preferred Phone. □ Home □ Business □ Cell Preferred Email: □ Primary □ Other Choose one level of authority, as defined above: Add Online Fund Access (includes the privilege to recommend grants from the Gift Fund) Add Online Fund Access “View Only” (does not include the privilege to recommend grants)

Examples of Preferred Phone in a sentence

• Smith or Xxx Xxxxx) HOME ADDRESS CITY STATE ZIP RELATIONSHIP TO DONOR DATE OF BIRTH (optional) BUSINESS OR ORGANIZATION NAME TITLE BUSINESS ADDRESS CITY STATE ZIP HOME PHONE BUSINESS PHONE CELL PHONE E-MAIL (preferred) Preferred Phone: □ Home □ Business □ Cell Preferred Mail: □ Home □ Business Successor Advisor 2 (if applicable): FULL NAME (first, middle, last) PREFERRED SALUTATION (e.g., Xx. Xxxxx X.

• Signature Signature Lessee NAME Guarantor NAME Permanent Mailing Address Permanent Mailing Address Preferred Email Address Preferred Email Address Preferred Phone Number Preferred Phone Number I attest that the above is accurate and consent for communication via any of these methods.

• Preferred Phone Number: Preferred email: Yes No A recorded message, text, or email to call the office for test results Yes No Communicate in person, or via phone, text, or email to anyone listed below regarding my health condition, test results (normal or abnormal), and medical history.

• First Name Last Name Title/Company Name City State Zip code Preferred Phone Preferred Phone Type Email Address Date of Birth Preferred Mailing Address ADDITIONAL CONTACT INFORMATION Role: (choose one) Donor: Individual has full advisory privileges, including grant recommendations, investment recommendations, naming of Successor Advisors and other Fund administration advisory privileges.

• Signature Signature xxxxxx@xxxxxxxxxxxxxx.xxx Lessee NAME Guarantor NAME Permanent Mailing Address Permanent Mailing Address Preferred Email Address Preferred Email Address Preferred Phone Number Preferred Phone Number I attest that the above is accurate and consent for communication via any of these methods.

• Print Sign Date SELLER: FULL ADDRESS: Preferred Phone: Preferred Email: 29.

• The Lessor’s information is as follows: Xxxxxxx Rentals LOCK BOX FOR PAYMENTS 000 X Xxxxx Xxxxxx, Xxxxx #0 Xxxxxxx Rentals Bloomington, IN 47401 P.O. Box 1248 812.339.8300 Bloomington, IN 47402-1248 xxxxxx@xxxxxxxxxxxxxx.xxx Lessee NAME Guarantor NAME Permanent Mailing Address Permanent Mailing Address Preferred Email Address Preferred Email Address Preferred Phone Number Preferred Phone Number I attest that the above is accurate and consent for communication via any of these methods.

• AGREED TO AND ACCEPTED AS OF THE DATE HEREOF Name of Individual/Company: Street Address: City: State: Zip: Preferred Phone: Ext: Signature By: Name of Signer By: Title: By: By: Xxxxx Xxxxxx, Managing Director Streamline Consulting Solutions Working Agreement For Corporate Funding Refinance And Profit System This AGREEMENT reflects our understanding, at the present time, of work to be done in support of Client/JV Partner’s funding.

• TENANT INFORMATION CO-SIGNER INFORMATION Name: Permanent Address: City, State Zip: Preferred Phone: Secondary Phone Primary e-mail: Secondary e-mail: Corrections/ Additional Info: Corrections/ Additional Info: LEASE CANCELLATION PERIOD: Tenant or Co-Signer has 5 days from lease signing to cancel this lease, (on or before ).

• Name: Address: Preferred Phone: E-mail: You must be a current Abacoa Community Garden Member IMPORTANT: Returning IP members should include payment with application.

More Definitions of Preferred Phone

Preferred Phone. □ Home □ Business □ Cell Preferred Mail: □ Home □ Business Please indicate the amount and nature of the opening contribution to the Gift Fund (check all that apply).

Preferred Phone. □ Home □ Business □ Cell Preferred Email: □ Primary □ Other Should this professional advisor receive “view only” online access to the Gift Fund? □ Yes □ No Section continues on the next page. Professional Advisor 2 (if applicable): □ Attorney □ Accountant □ Financial/Investment Advisor □ Insurance Advisor □ Mr. □ Mrs. □ Ms. □ Other First Name Middle Initial Last Name Preferred Name Firm Name: Street City State Zip Code Phone: Business Cell Email: Primary Other

Preferred Phone. Email: Caterer: Preferred Phone: Email: Cake: Preferred Phone: Email: Other Food: Preferred Phone: Email: Musician/DJ/Talent: Preferred Phone: Email: Management/AR Contact: Preferred Phone: Email: Winery/Alcohol Source: Preferred Phone: Email: Other Vendor: Preferred Phone: Email: Publicity/Media Contact: Preferred Phone: Email: Event Insurance Company / Policy # Primary Contact: Liquor Liability Insurance Co. /Policy # Cleaning Service / Tel Please understand that the Charleston Library Society cannot accept the risk of lack of insurance. No event can be hosted without proof of satisfactory insurance. Should you need help to source such insurance, the Charleston Library Society can provide contacts.

Preferred Phone. Email: _____________________________________ Name & address of work setting:__________________________________________________________ _____________________________________________________________________________________ Number of clients you see per week: ________________ Are you able to utilize EMDR in your work setting? Yes / No Are there other therapists utilizing EMDR in your work setting? Yes / No Types of clients and presenting issues with which EMDR will be utilized: _____________________________________________________________________________________ _____________________________________________________________________________________ If you have a Supervisor who is providing supervision towards licensure, please provide their name and contact information. _______________________________________________ Prior to learning EMDR, which psychotherapy models were you typically utilizing? ____________________________________________________________________________________ How long have you been practicing therapy? ____________ How long have you been practicing EMDR? _____________ With what aspects of EMDR are you most comfortable? _____________________________________________________________________________________ What aspects of EMDR are currently most difficult for you? _____________________________________________________________________________________ Fees Consultation groups for clinicians are $100/2-hour group ($75 for full-time non-profit employees) Please send your completed consultation agreement to me at least one week prior to the first group consultation session. I have read and understand and agree to the above conditions and expectations. ____________________________________________________________________________________ Consultee Name (print) Signature Date

Preferred Phone. Email: Address: City: State: Zip: For use on the event date and time stated above. Rental fee and non-refundable clean-up fee- due and payable prior to the event. Cash or Check is accepted as payment. (ALL PAYMENTS SHOULD BE MADE to Yakutat Tlingit Tribe-MEMO: SR Center) Non-Refundable Clean-up Deposit $50 Paid by: _ Method: Rental Fee: Paid by: Method: RATES: September- May: Afternoon Rate (2:30 pm – close) $100 June-August: Daily Rate $150 (Weekly rates available upon request) Weekend Rate (Saturday/Sunday all day) $150 per day All balances must be payable to Yakutat Tlingit Tribe in advance of the event. (If the balance has not been paid by the commencement of the event, the Yakutat Tlingit Tribe has the right to cancel your event.) Event/Seminar Detail Plan Resources Needed Extra chairs and tables: Media Requirements: Special Needs: Policies and Regulations CONDITIONS AND RESPONSIBILITIES OF _ (Renter) Please read the material below to make sure all parties understand the requirements of providing for everyone’s safety and keeping Yakutat Senior Center Rented Space a well maintained and safe location for future use. RENTAL FEES All balances must be payable to Yakutat Tlingit Tribe-Sr Center in advance. The rental payment, non-refundable clean-up fee, and the signed agreement, is required to reserve the date and space. Payment may be made by cash and check. No terms are implied or granted and no work will be allowed to commence until full payment is received.