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Interest form
Prevention Coalition of Mercer County
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Email
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Your email
First Name
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Your answer
Last Name
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Your answer
Your Cell/Text Phone
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Your answer
What are your areas of interest or action?
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Your answer
Are you a parent?
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We have a range of information for families of children of all ages. Check all that apply.
No
Yes, Infant/toddler
Yes, Elementary school age
Yes, Middle school age
Yes, High School Age
Yes, College Age
Yes, Adult Children
Other:
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Do you work or have interests in a sector or industry that could relate to prevention, addiction, or recovery?
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Your answer
Do you have social media that you would be comfortable linking to our group? Put none, if none is available.
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Your answer
Please consider following our blog and social media accounts.
www.mercercouncil.org/news
Facebook: PCoMC & MCPrevention Instagram: PreventionMercerCnty & Incorruptible.Mercer
Thanks for your interest! We look forward to working with you!
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