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Southeast PTTC Policy Community of Practice Registration Form
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Email
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Your email
Name
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What is your gender?
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Company Name
Your answer
Job Title
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Address 1
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City
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State
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Zip/Postal Code
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Has your coalition/group identified an alcohol, tobacco or other drug (ATOD) problem in the community that calls for a policy solution?
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Yes, we’ve identified an ATOD-specific problem
Yes, we’ve identified a problem but it is not an ATOD-specific problem
No, we have not identified a problem yet
Not sure
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