First and Last Name

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* 1. First and Last Name

Email

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* 2. Email

Address

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* 3. Address

Age Range

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* 4. Age Range

How many years have you lived in Claremont?

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* 5. How many years have you lived in Claremont?

What kind of Quality of Life Project would you like to see the City of Claremont invest in? Please rank your choices with #1 being your top choice.

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* 6. What kind of Quality of Life Project would you like to see the City of Claremont invest in? Please rank your choices with #1 being your top choice.

Other Quality of Life Project Suggestions:

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* 7. Other Quality of Life Project Suggestions:

Would you like to be involved in future events and projects, like Claremont Daze or Quality of Life, as a volunteer?

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* 8. Would you like to be involved in future events and projects, like Claremont Daze or Quality of Life, as a volunteer?

Would you like to receive information about the City and it's events throughout the year?

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* 9. Would you like to receive information about the City and it's events throughout the year?

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