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14
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1
Name
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First Name
Last Name
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2
Phone Number
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Please enter a valid phone number.
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3
Email
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example@example.com
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4
Age
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5
Gender
*
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Male
Female
Gender Variant/Non-Confirming
Prefer not to answer
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6
Do you have a disability?
*
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Yes
No
Prefer not to answer
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7
Do you have a driver's license?
*
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Yes
No
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8
Do you have another mode of transportation?
*
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Yes
No
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9
How often do you use any of Connect’s services?
*
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Multiple times per day.
Multiple times per week.
Multiple times per month.
Never.
I used to.
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10
Where do you typically take Connect?
*
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11
What does Connect mean to you? What role does it play in your life?
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12
Tell us about some of your favorite stories or memories about Connect. Did you meet some of your best friends on Connect? Have you taken it to a big life event?
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13
We know there's always room for improvement! What can Connect do better?
*
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14
By signing below, I understand a member of Connect staff may contact me for further interview. I understand that Connect may use my general demographic information including name and story in any of it's promotional activities, in perpetuity.
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