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Welcome to the Affiliate Registration page for Be The Evidence Project. Please fill out the information below so that we are able to create a database for all affiliates associated with this project.

If you have any questions, feel free to contact us at betheevidenceproject@gmail.com

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* 1. Organization Name:

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* 2. Address:

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* 3. Telephone:

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* 4. Contact Person’s Name and Title:

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* 5. Telephone number of Contact person:

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* 6. Email address of Contact person:

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* 7. Contact Person’s Name and Title:

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* 8. Telephone number of contact person:

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* 9. Email address of contact person:

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* 10. Type of Agency/Setting:

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* 11. Populations Served (children, adults, older adults, other):

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* 12. Types of Services Offered:

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* 13. Services for Criminally Justice Involved Individuals:

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* 14. Specific Types of Arts Programming:

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* 15. Website:

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* 16. Other Information:

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