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* 1. Your Name

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* 2. Your age

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* 3. Mailing Address

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* 4. Email address (for Zoom invitation)

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* 5. Best phone number

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* 6. Name & Age of most challenging child

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* 7. That child's sex

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* 8. Your relationship to that child

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* 9. Age/s of All Children (living with you or not)

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* 10. What type of household does the child live in?

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* 11. If you have a partner, will they also attend?

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* 12. How did you hear of us?

0 of 12 answered
 

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