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* I have attended FGWRC for family law support in the past.

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* I am interested in attending family law workshops and clinics at FGWRC.

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* Family law topic areas that are of interest to me are... (Check all that apply).

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* I would prefer attending workshops...(Circle all that apply).

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* I identify with the following group(s)...(This question is optional).

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* I have barriers that are preventing me from accessing support.

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* If yes, check all that apply.

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* Additional Comments:

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