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* 1. Facility Name:

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* 2. Customer Last Name or Business Name:

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* 3. Customer Zip Code:

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* 4. Gender

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* 5. Age Group

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* 6. Unit # (Enter PHONE for calls):

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* 7. How did you hear about the storage facility:

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* 8. Reason for Storing

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* 9. What is Stored

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* 10. Why did you decide to rent here ?

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