Join Healthy Climate New Mexico for Climate & Health Day at the Roundhouse, Monday, January 27, 2025, 9:00 AM - 3:30 PM. RSVP by filling out the form below.
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A vegan lunch will be provided. Do you have any food allergies? *
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Please invite your colleagues to join you. Please suggest any names (with emails) of people you’d like us to invite.
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We will do our best to support out of town travel. Do you need a travel stipend?
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