Thomas Zand Refugee Health Award Ceremony RSVP form
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Name *
E-mail Address *
Phone Number
Please indicate if you are *
Do you (or any one in your party) have any dietary restrictions? (Please specify)
The following questions apply to representatives from Worcester refugee serving organizations 
Name of the organization you represent 
Your role in that organization
Please indicate the number of people (including you) coming with you to the event? *
Do you want to set up a table to showcase your organization during the event? (We will contact you for details about this)
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