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* 1. Name

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* 2. Email Address

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* 3. Please check 'yes' if you do not already receive emails from us and would like to receive information regarding new products, newsletters, and webinars. Your information is safe with us and will never be shared with a third party.

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* 4. Name of your Facility

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* 5. State

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* 6. Country

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* 7. Please describe why you would like to take the Infant-Driven Feeding™ Course. Include in your response any information you can provide that makes your submission the "Most important" request for an IDF™ license that is more important than any other submission.

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* 8. What is your discipline?

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