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WI Doula Summit Registration Form
Please enter your information with current email and mailing address.  Your information will be used to notify you about this event, future doula summits, and any meetings or updates that are a result of the Summit. It will not be sold or used for any other promotions.
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Email *
Payment for the Summit. Please pay the SAME DAY you send in this form. If $20 is an issue for you or you want other payment options, email us at *
If you will not be attending, you can record a three minute video, upload it to a streaming service and put the URL below. Please fill out the rest of the registration form, any payment is optional.  If you list something here, we assume you won't be there in person. 
First Name *
Last name *
Business Name *
Website (Facebook page, etc.  How do people find your business on the Internet?)  If you don't have a website, etc., please enter n/a) *
Street Address *
City *
State *
Zip Code *
Phone number (xxx-xxx-xxxx) *
You may share my information with other Summit attendees (not your street address or zip code). *
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