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Please Enter Your Name: *
Please Enter Your Email Address: *
Please Enter Your Phone Number (if you wish to share):
Are you interested in participating in future meetings? *
What issues/concerns/interests are you interested in working on?
Are there are any activist/organizations that you are involved in or think this collective should be coordinating with?
Do you have access to a space that could host a working group or general meeting? If so, how many people could it hold? *
Do you have any special skills that you think would be valuable to the collective? (Optional)
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