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* 1. Email Address

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* 2. First Name

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* 3. Last Name

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* 4. Designation

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* 5. Organisation

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* 6. Are you an AVPN member?

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* 7. How are you empowering women and girls through the causes that you support?

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* 8. How would you like to continue building the community to empower women and girls?

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* 9. What kind of support are you looking for and how can AVPN support you?

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* 10. Would you like to subscribe to the AVPN newsletter for updates?

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