Request Form
Day of Event
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Date of Event (mm/dd/year)
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Time of Event
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Estimated Attendance
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Contact Name
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Phone Numbers: Office Cell Home
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Email Address
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Name of Organization
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Organization Complete Street Address
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Mailing Address if Different
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Purpose of Event (describe)
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Is this a 501(c)(3) non-profit organization?
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Media Coverage (type)
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Comments
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January 2010
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