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* 1. Your Name

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* 2. Organization (if applicable)

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* 3. Your Email Address

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* 4. Speaker and Topic Suggestions

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* 5. The following would increase the likelihood that I would attend an early childhood summit (Please check all that apply):

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* 6. How many representatives from your organization would attend an early childhood summit?

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* 7. I am interested in supporting an early childhood summit in Kent County in the following ways (please check all that apply and be sure to provide contact information):

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