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* 1. How likely are you to pay to participate in a webinar?

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* 2. Are you interested in obtaining CEU credit?

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* 3. What current licensures, certifications or credentials do you hold? 

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* 4. Advocacy: Tell us about the advocacy topics you are interested in learning more about. Feel free to be specific. Examples: Advocacy vs Lobbying, Basics, Working with elected officials, policies, etc.

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* 5. Community Action: Tell us about the community action topics you are interested in learning more about. Feel free to be specific. Examples: Community gardens, Faith-based strategies, food insecurity, worksite wellness, etc.

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* 6. Youth Engagement: Tell us about the youth engagement topics you are interested in learning more about. Feel free to be specific. Examples: The HYPE Project, Youth Engagement Strategies, Connecting youth with coalitions, etc.

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* 7. Communications/Marketing: Tell us about the communication/marketing topics you are interested in learning more about. Feel free to be specific. Examples: Social Media, Chapter Website Training, Paid Facebook Advertising, Success Stories, Desktop Publishing, etc.

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* 8. Coalition Capacity Building: Tell us about the coalition capacity building topics you are interested in learning more about. Feel free to be specific. Examples: creating bylaws/coalition structure, action planning, building relationships, fundraising, etc.

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* 9. Evaluation: Tell us about the evaluation topics you are interested in learning more about. Feel free to be specific. 

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* 10. Other: Tell us about other topics you are interested in learning more about. Feel free to be specific.

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* 11. Name

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* 12. Organization Name

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* 13. Coalition Name

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* 14. Email Address

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* 15. Phone Number

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