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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 Sex Designation/ Division Contact Preferred
Position Details (email, contact mode
mobile (email, phone,
number) Skype, Zoom,
Google Meet,
Viber, FB)

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