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Registration Form for "Celebrando a los Héroes en Quimica" Event
Registration Form
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Full Name
*
Your answer
Gothic Id if applicable
Your answer
Email
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Will you be attending?
*
Yes
No
Other:
Please indicate which Organization you are a part of.
Hispanic Association of Colleges and Universities
American Chemical Society
Jersey City Puerto Rican Heritage, Arts, and Culture
New Jersey City University
Saint Peter's University
Other:
Do you have any food allergies or require any
Special accommodations?
Yes
No
Maybe
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