Please answer the following questions so that we can submit the following in our petition to request HB/SB1451 be reversed and control returned to the municipalities as well as to help us stop the 5G roll out in our communitiies until independent scientific studies prove safe for humans.

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* 1. FULL NAME:

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* 2. TOWN:

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* 3. CELLULAR SERVICE PROVIDER CONTRACT WITH:

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* 4. NUMBER OF CELLULAR DEVICES IN YOUR HOUSEHOLD:

THANK YOU FOR TAKING THE TIME TO COMPLETE OUR SURVEY. 

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