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* 1. What is your Name?

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* 2. What is your street address?

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* 3. What type of shelter do you have?

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* 4. Where is your shelter located? (North of house, In garage, etc)

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* 5. How many people does your shelter hold?

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* 6. What is your phone number?

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* 7. What Fire District do you live in?

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