Thank you for your interest in applying for a 2016 CADCA GOT OUTCOMES! Coalition of Excellence Award. Please provide us with the following information in order to secure your spot for the applicant workshop on Wednesday, June 8th at 3-4:30PM EDT.
ABOUT YOUR COALITION:

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* 1. What is the name of your coalition?

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* 2. Please provide the city and state your coalition is located:

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* 3. What substance issue did your coalition successfully address that you are considering highlighting in your application?

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* 4. What level of outcomes have you achieved to date related to this substance issue? (Select all that apply)

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* 5. Has your coalition ever applied for a CADCA GOT OUTCOMES! Coalition of Excellence Award?

ABOUT YOU:

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* 6. What is your full name?

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* 7.

What is your title with the coalition?

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Please provide us with your contact information so we can send you the information you will need to connect to the application session on Wednesday, June 8th from 3-4:30PM EDT.  

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