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Regional representative registration
Designated NPHC representative for the Public Meeting at the 77th Western Province Council (March 15th, 2024 in Portland, OR)
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Organization
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Alpha Kappa Alpha, Far Western Region
Alpha Phi Alpha, Western Region
Delta Sigma Theta, Far Western Region
Iota Phi Theta, Far West Region
Omega Psi Phi, Twelfth District
Phi Beta Sigma, Western Region
Sigma Gamma Rho, Western Region
Zeta Phi Beta, Pacific Region
Representative's Name
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Representative's name as it should be presented/published (e.g. "Dr. Rebecca Lee Crumpler", "Macon B. Allen, Esq.", etc.)
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Email of representative
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Best email address to contact the representative
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Preferred contact number of representative
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Representative's phone number (preferably mobile)
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Public Title of representative
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Formal title of the regional representative as it should be printed/announced
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