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Community Clinic Association of Los Angeles County

Workforce Request Form

Workforce Request Form

CCALAC is excited to support new and existing partnerships and efforts with schools and organizations. If your school or organization would like for CCALAC to promote, support, or partner with you, please complete this form and the appropriate CCALAC team member will be in touch at the contact information you provided. Please allow up to 5 business after submission of this request form to hear back. Thank you.

Contact Information

FIRST and LAST Name of individual completing this form(Required)
Email(Required)

Request Details

Select your request from the list below. If not listed, please select "other" and write in the description box below.(Required)
Check all that apply.
Drop files here or
Accepted file types: pdf, jpg, jpeg, png, ppt, doc, docx, xls, xlsx, pptx, Max. file size: 16 MB.