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* 1. What is your first name?

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* 2. What is your last name?

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* 3. Phone Number

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* 4. Email Address

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* 5. In what DC Ward do you live? 

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* 6. What date(s) are you available to meet with your DC Council Member? (check all that apply)

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* 7. What time is the day are you MOST likely available for a meeting? (check all that apply)

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* 8. What issues are you interested in? (check all that apply)

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