CFWV Outreach Table Sign-Up

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* 1. School/Organization Name

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* 2. Name of Event

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* 3. Date of Event

Date

Date

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* 4. Time of Event

Start Time

Time

AM/PM

End Time

Time

AM/PM

Setup Time

Time

AM/PM

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* 5. Location of Event

Name

Address

City/Town

State/Province

ZIP/Postal Code

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* 6. Number of people expected at the event

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* 7. Contact Person

Name

Email Address

Phone Number

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* 8. Additional Info