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Joining Together to Accomplish More
Thank you so much for your agency participation. Your support is needed. Please complete the information below and submit it to secure your table.
Agency Name
First Name
Last Name
Agency Address (include city, state & zip)
Phone
Email
Event Name
Resources/Services Provided
Area(s) Served
How many staffers/volunteers are coming with you?
Is this your first time volunteering with City Wide Club?
Yes
No
How did you hear about us?
All agencies are responsible to provide their own tables, chairs and power
By clicking you agree with the above statement
I agree to indemnify City Wide Club of Club and its Chapters and entities from all liabilities
By clicking you agree with the above statement
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