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* 1. What is your name?

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* 2. Email?

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* 3. Will you be able to attend all 3 sessions?

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* 4. We would like to record the series for program development assistance. Do you give permission for us to record the series with you in attendance? (If we decide that we would like to use a clip for additional purposes we would reach out for further permission.) 

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* 5. Do you agree to keep your video camera on throughout the series (we understand that occasionally this needs to happen). 

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