The theme for the 2016 Sexual Assault Awareness Month is Prevention Is Possible.  Please be sure to submit your program by Friday, January 29, 2015

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* 1. PROGRAM TITLE

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* 2. PROGRAM DESCRIPTION

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* 3. PROGRAM TYPE

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* 4. PROGRAM DATE - Please provide and rank three dates for program to minimize conflicts with other events

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* 5. PROGRAM TIME

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* 6. PROGRAM LOCATION - Please reserve location prior to submission

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* 7. Would you be interested in collaborating with others if program is similar in nature? (Information would be sent to both sponsors)

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* 8. PROGRAM SPONSOR

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