Basic Information

Please fill-in below before completing the survey.

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* 1. Name

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* 2. Age

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* 3. Gender

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* 4. Are you Pomo?

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* 5. Phone

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* 6. Address

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* 7. Email

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* 8. Would you like to subscribe to our email or newsletter list? We send emails to announce special CIMCC events (about quarterly) and mail print newsletters (2-3 per year). Note: a PDF of the California Indian newsletter will also be available online a few weeks after mail-out on our website.

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