July 21, 2021 PREP Coalition registration

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* 1. First Name

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* 2. Last Name

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* 3. What is the name of the agency you represent?

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* 4. Phone number

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* 5. Email address

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* 6. Will you be joining us in person or remotely?

*Please note: to participate remotely, you must have access to a device that has video conference room capabilities (i.e., web cam, microphone, and able to download a driver from Zoom Meeting Rooms)*****

I will be at the Coalition Meeting in person

I will be at the Coalition Meeting remotely and have the necessary technology to actively participate in a video conference room

I can't participate in this Quarter's Coalition Meeting, but would like a recording of the meeting e-mailed to me

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* 7. Lunch will be provided. Do you have any dietary restrictions?

If you are joining us remotely, please leave this answer BLANK.

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* 8. Any questions or things you would like us to know?