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Thank you for your interest in the Acts Center for Applied Research. We look forward to exploring opportunities to help you with your research.

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* 1. Please provide your contact information:

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* 2. Your email address:

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* 3. Please confirm your email address:

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* 4. Please describe the topic of your research study:

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* 5. What is the approximate time frame for the study?

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* 6. Approximately how many respondents are you looking for?

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