Join Coffee and Conversations on the first Monday of the month at 2pm and the third Monday of the month at 7pm if you have children in middle or high school.

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* 1. Please provide your contact information.

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* 2. What county do you live in?

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* 3. What is your race?

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* 4. What is your ethnicity?

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* 5. Please provide your child's date of birth.

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* 6. What is your child's race?

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* 7. What is your child's ethnicity?

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* 8. What is your child's diagnosis? Please check all that apply.

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