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* 1. Contact Information

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* 2. Do you or any of your family members work in any of the following types of organizations?

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* 3. What is your gender?

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* 4. What is your age?

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* 5. Which of the following best describes your race or ethnicity?

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* 6. Please indicate your annual household income (combined income of wage earners in household)

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* 7. Do you have kids under the age of 18?

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