Friday, May 31st, from 10-2:30 pm

Complete the following form to register for the Southeast Spring Collaborative Meeting on Friday, May 31st from 10-2:30 at Jefferson Abington Hospital

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* 1. First Name

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* 2. Last Name

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* 3. Email Address:

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* 4. Confirm Email Address:

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* 5. Do you have any dietary restrictions or allergies?

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* 6. Which organization do you work/volunteer for?

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* 7. Please indicate any specific questions you’d like addressed at this meeting.

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* 8. Of the 3 break out rooms, 1) Doulas & Breastfeeding Support, 2) Donor Milk Updates and 3) How the Body Works (making milk, low milk supply, etc) which 2 will you be attending? *Must select 2*

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