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* 1. What is your first name?

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* 2. What is your last name?

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* 3. At what email address would you like to be contacted?

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* 4. What is the address where you would like your sign(s) delivered?

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* 5. How many yard signs would you like us to deliver?

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* 6. Can we count on your vote on April 6th?

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* 7. Do you have any other comments, questions, or concerns for Andrew Pelloso?

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