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* 1. What campaign are you considering for your media messaging?

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* 2. Contact Information

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* 3. Agency/Coalition Description

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* 4. What audiences do you want to target with the media materials?

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* 5. What is the target age range?

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* 6. What is your goal for the media campaign?

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* 7. What type of media materials are you considering?

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* 8. Do you want customized media materials to include your logo, website, phone number, etc.?

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* 9. Do you have an approximate date range for your campaign? 

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