Kuumba Lynx Intake Form
What KL service are you requesting?
Clear selection
Dates you are requesting (Start date)
MM
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DD
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YYYY
Dates you are requesting (End date)
MM
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DD
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YYYY
Times you are requesting (Start Time)
Time
:
Times you are requesting (End Time)
Time
:
Frequency of Event/Program
How many Expected attendees/participants
What do you believe is important for us to know about the demographics of the community/participants we will be engaging with? (Age, gender, community, cultural identity, etc)
Event Title/Program Name:
Venue Address/Site for program:
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