Ward 1 Community Meeting Registration

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* 1. Name

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* 2. Email

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* 3. Phone

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* 4. Will you be able to attend?

Yes

No

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* 5. How many guests will you bring?

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* 6. What are the names of the guests you will bring, if any?

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* 7. Please list any questions or concerns that you would like to have Dr. McKenzie to address during the meeting