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Imagine Summit Registration
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1.
First Name
(Required.)
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2.
Last Name
(Required.)
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3.
Email Address
(Required.)
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4.
Phone Number
(Required.)
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5.
City/ neighbourhood
(Required.)
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6.
Do you identify with any of the groups listed below
(Required.)
BIPOC
2SLGBTQI+
New Immigrant (Less than 4 years in Canada)
From a not for profit housing community
Women
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7.
Why are you applying to attend the summit
(Required.)
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8.
What vision do you want to see funded ( under 100 words)
(Required.)
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9.
Your company name ( put N/A if not applicable)
(Required.)
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10.
Tell us about your company ( under 50 words)
(Required.)