What is your name?

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* 1. What is your name?

What are your pronouns?

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* 2. What are your pronouns?

Please enter your contact information.

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* 3. Please enter your contact information.

We would like to make e-mail addresses available in a directory for members. Do you consent to sharing your e-mail address with other NCCP members?

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* 4. We would like to make e-mail addresses available in a directory for members. Do you consent to sharing your e-mail address with other NCCP members?

What is your work title, and what is the name of your organization?

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* 5. What is your work title, and what is the name of your organization?

What is your Twitter handle? (If you do not use Twitter, please answer, "N/A."

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* 6. What is your Twitter handle? (If you do not use Twitter, please answer, "N/A."

We promise not to share contact information with anyone outside of the membership. 

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