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* 1. Who are you trying to contact? Select all who apply.

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* 2. If you selected "Other" in the question above, please enter the person's name here.

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* 3. What is your name? (optional)

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* 4. At what email address would you like to be contacted? (optional)

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* 5. Phone number (optional)

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* 6. Please share as much detail as you can about the Code of Ethics violation.