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Charlie's Survey
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* Indicates required question
Where do you live? (City and state or province)
*
Your answer
How would you describe the climate where you live?
*
Check all that apply.
Warm
Mild
Moderate
Cold
Coastal
Inland
Humid
Dry
Arid
Damp
Salty
Wet
Urban
Polluted
Clean
Temperate
Tropical
Windy
Sunny
Required
At best estimation, when did you experienced burns from Charlie's?
*
(Take a guess if you need to, exact dates are not necessary if you can ballpark it)
MM
/
DD
/
YYYY
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