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Event Organizer Name *

Email Address *

Event Start Time

Hours

Minutes

Event website or social media

Start Date

End Date

Where will your event be hosted? *OnlineIn PersonHybridTBD

Please enter your virtual event link *

Event Name

Event Details

Flyer or image that best represents your event. For best results image size 3000px by 3000px

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Street Address *

Suite, unit, etc.

City *

Province/State *

ZIP / Postal Code *

Country *