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Lewiston Auburn Public Health Committee Members
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Healthy Androscoggin
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Membership Application
Membership Application
Your Name
(required)
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Job Title
Home Phone
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Best Time/Way to reach you||
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In what capacity would you volunteer your services?
(Check any that are of interest to you)
Media/Public Relations
Substance Abuse Prevention amoung Youth
Worksite Wellness
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Speaker Bureau
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Keeping Informed
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Membership Agreement
I certify that the above information is correct. I hereby agree to remain committed to the mission and goals of the Healthy Androscoggin Coalition.
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