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Name of Your Organization:

First Name:

Last Name:

Address:

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Email:

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Purpose of your organization:

Topics of special interest for presentation:

Date of presentation:

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Wheelchair accessible:

Yes      No

Type of event:

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Who comes to your meetings? (members, students, professionals, etc):

Cerebral Palsy Association of BC is a non profit organization, charitable registration 10690 4204 RR0001. We rely on membership fees and donations to do our work. An honorarium or donation to support our work would be appreciated.