Harley-Davidson Motor Officer Magazine Opt-in

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* 1. First Name

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* 2. Last Name

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* 3. Email address

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* 4. Are you Active/Reserve/Retired?

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* 5. What is your position title?

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* 6. What is the name of your Department?

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* 7. What is your department phone number?

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* 8. What is the address of your department?

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* 9. Does your department have a motor unit?

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* 10. What is the Make/Model/Year of your motorcycles?

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* 11. Do you want to receive communications from the Harley-Davidson Motor Officer Team including the Motor Officer Magazine?

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