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If you would like to contribute a one-shot, outtake, or original work to the Fandom Against Domestic Violence fundraiser, please fill out this form in its entirety. Contributions must be sent to fandomagainstdomesticviolence@gmail.com by Friday, January 21, 2011 for inclusion. The fundraiser will run from February 1-28, 2011. All donations will be made directly to The National Coalition Against Domestic Violence website. For more information, please visit: http://fandomagainstdomesticviolence.blogspot.com