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* 1. What is the name of the organization you are representing?

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* 2. What is your name?

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* 3. Please provide the top three community challenges your organization would like to discuss at the civic summit.

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* 4. Please provide us with one major "win" or accomplishment from your group since the last civic summit.

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* 5. Will you be attending the Civic Summit on Thursday, April 18th at 5:30pm?

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