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* 1. Please fill out the following information so we may contact you.

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* 2. Please describe your gender

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* 3. What is your age?

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* 4. Which of the following best describes your ethnic background?

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* 5. How many times a week would you say you drink coffee?

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* 6. How is the coffee you drink at home usually prepared THAT YOU CONSUME YOURSELF?

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* 7. Which, if any of the following types of coffee would you say you drink REGULARLY?

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