TC Suicide Awareness and Resilience Symposium 2024

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Who is registering?
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First Name* This field is required.
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Last Name* This field is required.
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Title/Organization or Community Member* This field is required.
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Email* This field is required.
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Phone Number* This field is required.
Area Code
Phone Number
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City/State* This field is required.
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Please indicate any dietary needs:
Vegetarian
Vegan
Gluten Free
Lactose Intolerant
Nut Allergy
No Pork
Other (contact ashlee.shields@ppchp.org)
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Please indicate any transportation needs:
From Cripple Creek
From Divide
From Florissant
From Colorado Springs
Should be Empty: