Thank you for participating in this survey! We appreciate any feedback we may receive from you. If your suggestion is chosen, we will contact you within 7 business days.


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* Please enter your suggestion for the Legal Services Department's name below.

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* Why do you prefer this name?

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* Please enter your design suggestion (if applicable) for the Legal Services Department's logo below.

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* Why do you prefer this design?

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* Do you have any other concerns, comments, or questions?

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* Please provide us with your contact information:

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* What is the best way to reach you?

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* May we disclose your name if your suggestion is the winning entry?

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* I certify that I am the author of the material I am submitting. The Arizona Coalition to End Sexual and Domestic Violence may reproduce, distribute, publish, display, edit, modify, create derivative works, and otherwise use the material for any purpose, in any form, and on all media.

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