YE-DFC - myGA

1. Contact Information

Name(Required)

First Last

Organizations/Agency (if applicable):

Job Title/Position (if applicable):

Email(Required)

Phone(Required)

2. Sector Representation

Please check the sector you represent or are interested in participating in:

3. Your Interest in Joining YE-DFC

• Why are you interested in becoming a member of the YE-DFC?

• What skills, resources, or expertise would you bring to the coalition?

Agreement and Signature

Signature(Required)

By signing below, you agree to actively participate in coalition activities and contribute to the goals of YE-DFC. You also understand that participation in the coalition is voluntary and involves collaboration with other stakeholders in the community.

Date

Youth Empowerment Drug-Free Coalition

1. Contact Information

2. Sector Representation

3. Your Interest in Joining YE-DFC

Agreement and Signature

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