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Family Resource Night - Resource Provider 
Event Time: 2pm-7pm (2-3pm) Set-up and Team Dinner
(3-7pm) Family Resource Night
**Event is once a month (3rd Tuesday of each month)
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Name *
Name of Organization Representing  *
Email Address *
Mailing Address *
Contact Number *
Number of people attending with you *
3-4 Sentences about mission/target population: *
Languages Spoken: *
Other Languages Spoken
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