One Small Step Questionnaire

Basic Information

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* 1. Name

First Name

Middle Initial

Last Name

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* 2. City of Residence

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* 3. State of Residence

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* 4. ZIP code

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* 5. How did you hear about One Small Step?

Friend, colleague, or family member

NPR or local radio station

Facebook

StoryCorps website

StoryCorps podcast

Email from StoryCorps

Group, organization, or congregation I belong to

Other (please specify)

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* 6. If applicable, what is the name of your group, organization, or congregation?