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Inner City Education Initiatives
Job Creation for Neurodivergent Individuals
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CAI Cares Chapter Participation Form
Work Information
Associate Full Name
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Associate ID
Account Name
Account Address
Personal Information
Home Address
City, State
Zip Code
Preferred Email Address
Preferred Phone Number
Preferred Method of Communication
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Email
Phone
Text
Desired Chapter Affiliation
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Bangalore, India
Diamond (DE)
Harrisburg, PA
Lehigh Valley, PA
Midwest
North Florida
South Florida
Three Rivers (Pittsburgh, PA)
Consent for storing submitted data
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