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Black Girl Digital Awards Gala

This form is for those interested in attending Black Girl Digital Awards Gala in Atlanta, Georgia. Entries do not guarantee attendance. Must be 21+ to attend.

Name

First Name

Last Name

Birthdate

YYYY

Phone

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###

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Which city do you reside in?

Can you attend the Black Girl Digital Summit Nov 1-3rd ?

Tell us why you want to attend the Black Girl Digital Summit?