Public Affairs Calendar Form: California Alcohol and Drug Programs

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Public Affairs Calendar

Online Public Affairs Calendar Form

Public Affairs Calendar Form

The items below followed by an asterisk (*) are required fields.

First Name:*
Last Name:*
Event Name:*
Event Date:*
Event Time:*
Event Location:*
Contact Name:*
Contact Phone:*	no hyphens or spaces; ex:1234567890
Contact E-mail:*
Website:
Description of Event:*
	Please enter the number from the image below to varify *

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Public Affairs Calendar Form