Which of the following describes you? (Check all that apply.)

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* 1. Which of the following describes you? (Check all that apply.)

Please choose which age group you and/or your family are the most passionate about regarding issues that impact those with differing abilities. (You may choose more than one.)

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* 2. Please choose which age group you and/or your family are the most passionate about regarding issues that impact those with differing abilities. (You may choose more than one.)

What issues faced by people with differing abilities are you most concerned about? (You may choose more than one.)

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* 3. What issues faced by people with differing abilities are you most concerned about? (You may choose more than one.)

Do you currently receive information from advocacy groups?

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* 4. Do you currently receive information from advocacy groups?

Would you like to receive information on ways that you can help us advocate about critical issues that affect those with differing abilities?

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* 5. Would you like to receive information on ways that you can help us advocate about critical issues that affect those with differing abilities?

How do you prefer to receive information?

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* 6. How do you prefer to receive information?

Do you have a Facebook account?

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* 7. Do you have a Facebook account?

Do you prefer other forms of social media?

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* 8. Do you prefer other forms of social media?

Thank you for your time and your insights. Please provide any additional comments here.

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* 9. Thank you for your time and your insights. Please provide any additional comments here.

If you would like information about advocacy issues and events, please leave your name and email address below.

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* 10. If you would like information about advocacy issues and events, please leave your name and email address below.

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