Community Gathering Host - Basic Information
For those interested in hosting a community gathering. Your basic information will be used to plug you into the political healers’ network, creating an open line of communication and collaboration between you and other community gathering hosts. We pledge to keep your information private, only available for the internal coordination of our work.
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Email *
First Name *
Last Name *
Email Address *
Phone *
Secondary Phone (if available)
Gender Pronouns *
Required
Racial ID *
Address1 *
Address2
City *
State *
Zip Code *
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