CDSS Affiliate Survey - Requests for Future Webchats
(July 2018)

Your Information

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* 1. Your Name

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* 2. Are you an individual/family member of CDSS?

Yes

No

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* 3. Your Local Dance or Song Group

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* 4. Is your local group a CDSS Affiliate?

Yes

No

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* 5. State/Province

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* 6. Country