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1
Location
Zip Code
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2
Full Name
First & Last Name
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3
Contact Info
Phone & Email
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4
Gender
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Gender
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Other
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5
Birthdate
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Month
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Day
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6
Household
Size & Income
Household Size
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$0 to $59,000
$59,001 to $94,000
$94,001 and over
Include all family members and annual household income
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