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Please Enter Your Name:
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Please Enter Your Email Address:
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Please Enter Your Phone Number (if you wish to share):
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Are you interested in participating in future meetings?
What issues/concerns/interests are you interested in working on?
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Are there are any activist/organizations that you are involved in or think this collective should be coordinating with?
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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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