Community Supported Cafe

1. About You

We want to get to know you. Please fill out these questions. All responses are anonymous if you want them to be. If you provide us if with your name and contact information we will provide you with a $5 gift certificate towards the Local Sprouts Cafe.
1. Please fill out only the information you want to fill out on this form. If you do not want to provide your name or address we would love to get what town you live in.
2. How old are you?
3. Which Portland Neighborhoods do you frequent?
I live hereI work hereI visit friends hereI shop hereI pass through hereI go here once a weekI go here once a monthI go here a couple times a yearI hardly ever go here
East End
Downtown btwn Franklin & Forest
Arts District btwn Forest & State
East Bayside
Old Port
West End
North Deering
Woodfords Corner
Back Cove
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