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* 1. First Name
Nombre

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* 2. Last Name
Appellido

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* 3. Telephone Number/ número de teléfono

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* 4. City of Residence/ ciudad de residencia

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* 5. Zip Code/código postal

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* 7. E-mail/correo electrónico

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* 8. Primary Language at home?/ idioma principal en casa

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* 9. I am answering this survey as a/Estoy respondiendo a esta encuesta como

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* 10. Which race/ethnicity best describes you?/¿Qué raza o etnia te describe mejor?

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* 11. Which gender best describes you?/¿Qué género te describe mejor?

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* 12. Would you like to be added to WarmLine's E-newsletter?/¿Quieres que te agreguemos al boletín electrónico de WarmLine?

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20% of survey complete.

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