Registration Form for Community Health Improvement Plan Stakeholder Meetings
We are offering both in-person and virtual options; we hope to see the local community provide valuable feedback, which is crucial for ensuring that the plan is reflective of the community's needs, concerns, and goals.
Which stakeholder meeting do you plan on attending?
Thursday, March 7 from 5:30-6:30 PM at the Roger Marten Community Center located at 120 S Franklin St, Mondovi, WI 54755.
Tuesday, March 19 from 5:30-6:30 PM at the CFC School auditorium located at S2770 State Road 35 Fountain City, WI 54629.
Friday, March 22 from 12:00-1:00 PM for a virtual meeting. A zoom link will be sent to the email address you list below.
Attendee Information
Please fill name and contact information of attendees.
Your Name
Mr.
Mrs.
Miss.
Prefix
First Name
Last Name
Contact Number
Please enter a valid phone number.
Email Address
example@example.com
Will you have a guest with you?
Yes
No
Guest Name
Mr.
Mrs.
Miss.
Prefix
First Name
Last Name
Email Address
example@example.com
Contact Number
Please enter a valid phone number.
Would you like to be updated about the upcoming events?
Yes
No
Submit
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