Local DSA Collaboration Application
Organization name as it will be used on signage, program, social media, etc.
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Contact Name
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First Name
Last Name
Email Address
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example@example.com
Phone Number
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Please enter a valid phone number.
Organization Website
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List your social media accounts where you will promote the retreats:
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Please upload your logo (png or jpg). Alternatively, please email your logo to info@dsdiagnosisnetwork.org. This logo will be used on social media and retreat materials.
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Would you like to purchase 5 registrations for the price of 4? (If you'd like to purchase more than 5, please comment below)
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Yes
No
Any questions or comments?
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