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* 1. Organization Name

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* 2. Your Name

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* 3. Your e-mail address

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* 4. Best number to reach  you

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* 5. What is the address of where the workshop will take place?

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* 6. Which workshop would you like to host?

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* 7. If you chose College Prep, how many workshops can you host?

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* 8. If you chose Early Childhood, how many workshops can you host?

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* 9. If you are hosting an Early Childcare workshop, are you able to provide childcare?  (This is not a requirement.)

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* 10. When would you be able to host the workshops?  If you have specific dates, please include below.  Otherwise, please include   the month, and if possible, the week.

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* 11. When would you like your workshop?

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* 12. Our workshops are traditionally conducted in Spanish.  Will you need your workshop to be in English?

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* 13. Would you be able to register at least 35 people to attend the workshops, promote workshops, and collect RSVPs?

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* 14. Please include information about how you will reach out and share the opportunity with parents. 

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* 15. Please include any additional information that is important for us to know about your community or parents and  children that would allow us to better serve them.

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* 16. Please list the type of space the workshop will be held in (i.e. classroom, gym, auditorium).

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* 17. Who will be the site contact? Include name and title.

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* 18. Please provide site contact email and phone number below.

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