Form 1. LAC Profile

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FORM 1: LAC PROFILE

This form should be accomplished by the LAC Facilitator and its members at the first LAC session.

REGION:

LAC ID (name or number): Number of LAC members:

Name of LAC Facilitator: Designation/Position:

LAC Members
NAME Male/ Female DESIGNATION DIVISION/S Contact details Preferred contact
/ POSITION (email, mobile mode (email, phone,
number) Skype, Zoom, Google
Meet, Viber, FB)

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