Community Champion Registration
Sign me up as a Children’s Mental Health Matters! Community Champion. I agree to participate in this effort to raise awareness of children’s mental health.
Organization *
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First Name: *
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Last Name: *
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Your Title *
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Email: *
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Phone:
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Mailing Address *
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Website URL:
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My organization is a: *
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Is your organization active on social media? If so, please provide your URL or username for Facebook, Twitter, etc.
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Please select any jurisdiction in which you plan to share Campaign information:
How did you hear about the Campaign?
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