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Minority Health Partners Website Directory Survey
Our 2022 MHP Conference provided excellent networking! Let's continue the collaboration with a digital directory on the website. Please complete this short eight (8) question survey to be included on the website directory.
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1.
Organization Name
2.
Organization Website
3.
Organization Physical Address
Please include street name, city, state, and zip code.
4.
Organization County
5.
Organization Community Outreach Point of Contact
First and Last Name
Email Address
Work Phone
Mobile Phone (optional)
6.
Organization Main Services
Please share a short two sentence overview of the services provided direct to the community.
7.
Organization Social Media Handles
Twitter
Facebook
Instagram
TikTok
Other
8.
Please upload your logo.
Please upload only .png or .jpeg files.
Choose File
No file chosen
9.
Other information you would like to share with Minority Health Partners community: