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| Position: | |
| Local CTA President | |
| Local CTA Bargaining Chair | |
| Local CTA Organizing Committee Chair | |
| CTA Board Member | |
| St. Council Negotiations Cmte | |
| CTA/NEA Staff | |
| CTA/NEA Manager | |
| Leaders: What is the name of your CTA Staff Person? | |
| Local Chapter, RRC, UniServ or Dept Name: | |
| Office/City Location: | |
| Office/Association Phone: | |
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