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* 1. Do you plan to attend the Global Gag Rule convening December 4-6, 2019? Please note: December 4 is a civil society only day. 

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* 2. Please provide your contact information

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* 3. Please indicate your grantmaking areas of focus (choose all that apply)

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* 4. Please indicate the type of institution (please only select one)

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* 5. In which geographic areas do you fund? (please select all that apply)

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* 6. What do you hope to gain or contribute by participating in the convening?

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* 7. Do you have any initial questions or comments for us?

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* 8. Will you require translation in French or Spanish?

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* 9. Do you have any food allergies or dietary restrictions we should try and accommodate?

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