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STAQS Dates and Location:
August 20-21, 2019
Muhammad Ali Center, 133 N. 6th Street, Louisville, KY  40202
(502) 584-9254

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* 1. Last Name, First Name

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* 2. E-mail Address

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* 3. Agency/Business Name  or write "Private Citizen"

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* 4. Agency Street Address

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* 5. Agency City, State, and Zip Code

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* 6. Agency Phone Number

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