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Reporting to Motheread® Arizona

Schedule Report

This report is due before the start of each Motheread® Arizona adult discussion series.

Trained Motheread® Arizona facilitators
Name(s):
Organization:
Address:
City:
 State:
 Zip Code:
Phone:
 Fax:
E-Mail(s):
Discussion Series Location (if different than above)
Name:
Address:
City:
Discussion Series Schedule

Dates (list each one):

Times of day of sessions:
Community Partners (note contribution of partner):

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