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* 1. What is your name?

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* 2. What is your phone number?

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* 3. What is your email address?

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* 4. What is your address?

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* 5. What are your preferred acting days? (please check all that apply)

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* 6. What time of day are you available for acting? (check all that apply)

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* 7. In which of the following areas would you prefer to perform? (please check all that apply)

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* 8. Would you be willing to travel outside of the New York metropolitan area?

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* 9. How did you learn about InterACT New York?

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* 10. Please add any relevant experience or information.

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