Tobacco Free Pasco Membership Form (FY 22-23)
Please take a few minutes to complete our membership form so that we can get to know you and your organization better. We look forward to working with you all to prevent nicotine addiction in our community. Thank you in advance for your time!
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First Name *
Last Name *
Preferred phone number *
Email address *
Name of Organization where you work and your role *
Are you a previous TFP member? *
Availability for TFP meeting (please select all that work best with your schedule) *
Required
Would you prefer virtual or in-person quarterly Partnership meetings? *
Are you interested in pursuing a future leadership role with Tobacco Free Pasco? *
What do you think Tobacco Free Polk should be focusing on in Pasco County? *
Is there anything else you would like to share with us?
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