Thank you for taking the time to RSVP your attendance!

The Zoom invite will be sent via email, so please keep an eye out!

If you have any questions, please contact Andrea Pollock at (216) 990-0524, apollock@fcsohio.org OR Christie Gigliotti at (440) 205- 2694, cgigliotti@lgrc.us

1.Are you able to attend the Health Equity Introduction Meeting?

Yes

No

2.If you can not make this meeting,  would you like to stay listed for future correspondence?

Yes

No

3.Which community sector would you identify with?

GovernmentCommunity OrganizationSchool/EducationBuisnessHousingFaith Based/ReligiousCivic AssociationMediaInvolved CitizenHealth/Medical ProviderLaw EnforcementOther (please specify)

4.Contact Information

Name

Organization

Position Title

City/Township

ZIP/Postal Code

Email Address

Phone Number