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1. How did you hear about the Lawsuit Reform Alliance of New York?

2. What is your gender?

3. Which category below includes your age?

4. What industry or profession do you belong to or represent?

5. Which issues are you most concerned about? Select as many as apply.

6. In general, LRANY contacts me:

7. I am interested in having a member of LRANY speak to my business or event

8. What do you feel the Lawsuit Reform Alliance could do differently to better serve its grassroots supporters?

9. Name and address (required to receive mug)