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Community Event Pre-Registration

Join us for interactive experiences designed to create awareness and offer a path to preventing falls.

Event 9:00am-12:00pm
UWO-Fox Cities Campus
1478 Midway Road, Menasha, WI

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* 1. Please enter your first name:

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* 2. Please enter your last name:

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* 3. Please enter your street address (including house number, apartment number or room number):

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* 4. Please enter your city/town/village:

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* 5. Please enter your state:

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* 6. Please enter your zip code:

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* 7. Please enter the county where you reside (Calumet, Outagamie, Winnebago, etc):

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* 8. Please enter your email address (you will receive an email reminder before the event):

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* 9. Please re-enter your email address for confirmation.

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