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* 1. Contact Information

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* 2. Which of the following best reflects your past and/or current relationship to NCCJ? (Choose all
that apply)

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* 3. Which programs have you been involved with/in? Please check all that apply

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* 4. How have NCCJ programs and/or events impacted you? 

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* 5. Do you think NCCJ programs have impacted your community? If so, in what ways?

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* 6. What changes do you know of or have you witnessed that you attribute to NCCJ programs or support?

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* 7. In 1-2 sentences, what would you say to someone considering participating in a NCCJ program? 

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* 8. Would you like to share a photo or GIF of yourself?

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

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* 9. Do you give NCCJ permission to include your name with your testimony in grant applications?

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* 10. Do you give NCCJ permission to include your name with your testimony for marketing purposes?

Thank you so much for providing your thoughts and sharing your experiences with us! Your willingness to share helps to ensure the continued success of NCCJ! 

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