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Email *
NAME *
PERSON FILLING OUT FORM - IF SOMEONE ELSE WILL BE ATTENDING THE WORK GROUP MEETINGS - YOU CAN SPECIFY BELOW.
PHONE *
Please share most direct contact phone for reach you.
WORK GROUP *
Check any WORK GROUPS your org/school would be interested in participating in. 
Groups will meet 4-8 times per year and then report back to the Community Collaborative quarterly.
We may not start with all of them but it will help to know who is interested.
Required
ORGANIZATION *
PLEASE CHOOSE BELOW - IF YOUR ORG or SCHOOL is not listed, please let us know the name in comments below.
COMMENTS & QUESTIONS *
Share any comments or questions - If your org was not listed above and you selected OTHER, please put the name of your org here. If someone else in your org will be attending the work group, please put the name and contact info of the individual(s) and which meeting they will attend.
A copy of your responses will be emailed to the address you provided.
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