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2. First Name*
3. Last Name*
5. Address1*
7. Address2
9. City*
10. Zip*
12. What is your Council District
    -- Select One --District 1District 2District 3District 4District 5
13. Council District Map
    Council District Map
15. Email Address*
16. Contact Phone Number*
18. We would like to take more photos during the program to help with promotional materials and social media. Do we have your permission to share photos that you may be in during the program?*

    1. YES
    2. NO
20. Are you able to participate in at least six of the seven sessions? With high demand for the program we want to ensure participants are able to make the most of it.*

    1. YES
    2. NO
22. Why are you interested in CGA and what do you hope to learn?
24. How did you hear about the CGA?
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26. 1. Receive an email copy of this form.
27. Email address

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28. Submit

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