Lesbian Woman's Social Group Registration

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* 1. What is your name?

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* 2. What are your Pronouns?

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* 3. What age range do you fall into?

45-54

55-64

65+

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* 4. What is your phone number?

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* 5. What is your Email Address?

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* 6. What is your zip code?

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* 7. How did you hear about the Lesbian Social Group?

Avenidas Website

Local Newspaper

Meet-up App

Local community center or agency

Online search

Other (please specify)