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We want to learn about you
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Email
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Your email
Last Name, First Name
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Your answer
Street Address
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Your answer
City, State and Zip
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Your answer
Mobile Number
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Your answer
Gender
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Female
Male
Are you currently a member of HBCC or any other Chamber of Commerce? If so, please list them.
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Your answer
What is your highest level of education completed?
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Less than a high school diploma
High School Diploma
Trade School
Some College
College Degree
Advanced College Degree
What social media platforms do you use? Please provide your handles.
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Race/Ethnic Identity
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Black/African American
Hispanic
Asian
Islander/Pacific Asian
White
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Other:
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How did you hear about HBCC and the Recovery Program
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Friend or Family Member
Social Media or Website
Media (Newspaper, Radio or TV)
I am a HBCC Member
Other:
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