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Name
*
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Dr.
Dr. and Mrs.
Miss
Mr.
Mrs.
Mr. and Mrs.
Ms.
Title
First Name
Last Name
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One Time
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Address
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Address Line 1
Address Line 2
City
State
Zip
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Email
*
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$
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Phone
*
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Please select which luncheon you will attend
*
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Tuesday, August 24: 12:00 PM - 1:00 PM - Cedar Rapids @ the HYFC Office
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One Time
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How many spots would you like to reserve?
*
$
$
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Please include 1 spot for yourself, plus the number of guests you are bringing.
Please list the names of your guests
*
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$
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Please list any food allergies if applicable
*
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$
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Best time to follow up?
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Morning
Afternoon
Evening
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We will use this information to follow up with you after the event.
How would you like to receive YFC updates?
*
$
Email
Mail
Both
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Who invited you?
*
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$
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