* 1. First Name

* 2. Last Name

* 3. Email

4. Phone number

* 5. Will you attend the March 6, 2013 screening of Weight of the Nation (Consequences)?

* 6. Will you attend the March 13 screening of Weight of the Nation (Choices)?

* 7. Will you attend the March 20 screening of Weight of the Nation (Children in Crisis)?

* 8. Will you attend the March 27 screening of Weight of the Nation (Challenges)?

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