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1. Please select the top 3 (three) issues you want state lawmakers to focus on:

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2. Please select the top 3 (three) issues you believe the state is doing well on:

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3. What policy change or law would make the biggest difference in your life?

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4. How would you like Rep. Street to connect with you?

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5. Do you feel Washington is going in the right direction?

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6. Do you feel lawmakers are responsive to your concerns?

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7. Please leave your name and your email/phone number if you'd like a personal reply.

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