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First Name
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Last Name
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Date of meeting you're attending
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Email Address
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Would you like to receive emails about future meetings?
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Is this your first La Leche League meeting?
Yes
No
No, but it's my first with this Group
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Are you a La Leche League member?
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No
No, but I'm interested in membership
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Tell us about yourself...
I am currently breastfeeding/chestfeeding/human milk feeding
I plan to breastfeed/chestfeed/human milk feed
I am a support person (who used to breastfeed/chestfeed/human milk feed)
I am a support person (not breastfeeding/chestfeeding/human milk feeding)
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