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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. Phone number

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* 5. Will you attend the March 6, 2013 screening of Weight of the Nation (Consequences)?

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* 6. Will you attend the March 13 screening of Weight of the Nation (Choices)?

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* 7. Will you attend the March 20 screening of Weight of the Nation (Children in Crisis)?

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* 8. Will you attend the March 27 screening of Weight of the Nation (Challenges)?

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