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* 1. Please indicate your first and last name

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* 4. For this first round of the program only, it is as a "pay what you can" set up. Please indicate what you would like to pay for this program and before the program start date I will send you an invoice for that amount.

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* 5. Please provide your email so we can get you all set up for the program emails.

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* 6. YAY! You're all set! See you in there! Please let me know if there is anything else you would like to add. 

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