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* 1. Which statement do you identify most closely with?

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* 2. What race do you best identify with?

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* 3. Do you know when the census should be filled out?

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* 4. Do you need help filling out the census?

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* 5. How comfortable are you with filling out the census?

1 (Not comfortable) 5 (Very comfortable)
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* 6. What are your concerns regarding the census?

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* 7. Why is the census important to you?

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* 8. Do you have any other comments or questions?

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