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2. 2023 Giving Blood, Sweat & Tears!

   Please include your name, municipality, and possibly a photo of you giving blood. 

3. 
5. First Name*
7. Last Name*
9. Municipality*
11. Photo Upload

    Not required, but if you have one - we would love to see it!

13. Brought to you by the WMCA Promotions Committee

    Chair Aja Taylor WCMC/CMC, City of Lancaster

    Jerri Johnson, City of Adams

    Linda Kuhlman WCMC, Village of Brooklyn

    Michelle Luedtke WCMC/CMC, City of Brookfield

    Lisa Moen WCMC, Village of Cambridge

    Susan Westerbeke WCMC, City of Port Washington

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

    This field is not part of the form submission.

17. Submit

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