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* 1. First Name

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* 2. Last Name

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* 3. Cell Phone

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* 4. Accept text messages

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* 5. What UFCW Local do you belong to?

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* 6. Email address

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* 7. Store Number

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* 8. How many years have you worked for Rite Aid?

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* 9. What is your current rate of pay?

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* 10. Are you full-time or part-time?

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