Tell us about you!
First & Last Name
Social Media Handle
Ex. Instagram, Twitter, Facebook
Are you a Polka Dot Power House Member?
Yes - Worcester Chapter
Yes - Visiting member
No - Would love to join
No - Not interested in joining
Have you attended a Polka Dots Meeting before?
Visiting Sister - Which Chapter are you visiting from?
How did you hear about this speaker opportunity?
Summarize your presentation:
Should be Empty:
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