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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. What state do you reside in?

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* 4. Which specific issue(s) do you believe should be an NBCC priority?

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* 5. Why do you believe this issue should be an NBCC Public Policy Priority?

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* 6. How does your suggested issue fit into NBCC's strategic priorities?

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