* 1. Do you live in Holland Charter Township? If not what City, Village or Township?

* 2. Please select your gender.

* 3. What is your marital status?

* 4. How many people currently live in your household?

* 5. How many people in your household are:

  0 1 2 3 4 5+
Less than 6 years old
6-17 years old
18-24 years old
25-44 years old
45-64 years old
65 years or older

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