Name

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Age Range

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What is your full name (first and last)?

What state do you live in?

What is your zip code?

How would you characterize the place where you live?

RuralUrbanSuburban

What is your primary organization affiliation?

What other food and agriculture organizations are you involved with?

Do you grow any of your own food?

YesNo

Website address #1:

Website address #2:

What aspect of food and agriculture are you most passionate about?

Clear