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Day Pass Voucher Application

For frequently asked questions about Day Pass Voucher for nonprofit organization click here. If you have any further questions please contact us at 214-749-3400 or email us at [email protected]

Complete the form for nonprofit organization that purchases Day Pass vouchers only. Click [ Submit Application ] when done.

* Required Field
Employer ID Number (EIN) *
An Employer Identification Number (EIN) is also known as a federal tax identification number, and is used to identify a business entity or nonprofit organization. The EIN is issued by the Internal Revenue Service.
Use numbers only (ex. 1234567890)
Name of Company *
Address 1 *
Address 2
City *State * Zip *
Contact Name *
Phone * X Use numbers only (ex. 1234567890)
Fax Use numbers only (ex. 1234567890)
E-Mail Address
Comment
 
Verification Code
Enter code as shown below with no spaces.
This helps prevent automated requests.

Enter code:


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