World Suicide Prevention Cycle the Globe

Thank you for joining the Burlington County "Cycle Around the Globe" for World Suicide Prevention Day.
Please submit the distance you cycled on Friday, September 9, 2016 and/or Saturday, September 10, 2016 supporting Burlington County's Efforts in Suicide Prevention and Awareness. We will submit our cumulative miles to the World Suicide Prevention website.

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* 1. Distance cycled:

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* 2. Please complete the information below if you would like to receive a Cycle Around the Globe Certificate. This is optional information but please at least indicate your township.

Name:

Address:

City/Township:

email:

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* 3. Would you like to receive information on future Suicide Prevention and Awareness events?

Yes

No

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* 4. Comments:

"No Act of Kindness However Small Is Ever Wasted." Aseop