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PEER-A-PALOOZA Conference Committee Application

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NAME

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EMAIL

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PHONE

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Why do you want to be a part of the Conference Committee?

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What does the word "empowerment" mean to you?

If you are interested in being a Chair or Co-Chair for any Committee(s), please list which Committee(s) you are intersted in.

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What is your availability for Conference Calls? Please list days and times.

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What City/Town do you live in?