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* 1. First Name

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* 2. Last Name

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* 3. Zip Code

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* 4. Is there anything you would like to share with the project team?

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* 5. How did you hear about this online open house? (Check all that apply.)

Mailing List (Optional)

Provide the following optional contact information if you would like to be added to the project mailing list.

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* 6. Organization

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* 7. Email

Demographic Information (Optional)

This project is requesting demographic information to evaluate the effectiveness of public outreach activities. The identity of individuals is kept confidential. The results are reported as totals only, and used solely to help improve future community engagement. Providing this information is voluntary and optional.

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* 8. What is your age?

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* 9. Gender (Check one.)

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* 10. Languages spoken at home (Check all that apply.)

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* 11. Your Race/Ethnicity (Check all that apply.)

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