2014 ECM Work Day Group Registration

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Please fill out this form to confirm your group's registration for an ECM Work Day. The contact person should be the Group Leader, who is the individual ECM will direct communication toward moving forward.

Date of ECM Work Day *

YYYY

Group Name *

Anticipated Number of Volunteers *

Reason for Participating in an ECM Work Day *

One time project for our group this year

Multiple opportunities to participate in projects this year

Desire to build an ongoing relationship with ECM

Other:

Required

I have reviewed the "Getting Involved in ECM" document *

Yes

First Name *

Last Name *

E-Mail Address *

Cell Phone Number *

(###.###.####)

Street Address *

Apartment/Suite

City *

State *

Zip Code *

Any other questions?

Submit

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