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Email
*
Your email
Parent/Guardian name
*
Your answer
Child Name #1
*
Your answer
Child #1email
*
Your answer
Child Name #2
Your answer
Child #2 email
Your answer
Age and Grade of Student/s
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Your answer
School attended
*
Jefferson Middle School
Lange Middle School
Benton Elementary
Locust Elementary
Columbia Independent
Other:
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If other was chosen in the last question, please let us know where your child attends.
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