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2. Name
4. Email Address
6. Phone Number
8. Organization

10. Workshop Information
    
    Review the following information and select the workshop you would like to attend. 
    
    

    • Tuesday, January 13, 11:30 a.m.-1:30 p.m.
      Southern Human Services Building, Board of Commissioners Meeting Room (Google Maps)
       2501 Homestead Road, Chapel Hill, NC
    • Thursday, January 15, 5:30-7:30 p.m. 
      Whitted Human Services Building, Donna Baker Meeting Room (Google Maps)
       300 West Tryon, Street, Hillsborough, NC

    • Tuesday January 20, 11:30 a.m.-1:30 p.m.
      Online workshop. A Teams link will be sent to you when we receive your registration form. 
      
      
    • Thursday January 22, 5:30 -7:30 p.m.
      Online workshop. A Teams link will be sent to you when we receive your registration form. 
12. Workshop Selection

    Select the date you would like to attend our grant application workshop:

    1. January 13, in Chapel Hill
    2. January 15, in Hillsborough
    3. January 20, online
    4. January 22, online
14. Thank you

    I look forward to seeing you! If you have questions, reach out: 
    
    Tonya Stancil, Harm Reduction Coordinator
    tstancil@orangcountync.gov
    919-245-2429 

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16. 1. Receive an email copy of this form.
17. Email address

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