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* 1. Name

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* 2. Email

Will only be used if you win a Harris Teeter gift card

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* 3. What age group do you belong to?

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* 4. What is your current household status?
(Select all that apply)

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* 5. What is your annual household income?

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* 6. What is your highest level of education?

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* 7. Which of the following best describes your relationship to NoMa?
(Select all that apply)

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