Your email: (Please write your email carefully and double check its accuracy before moving to the next question) *
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Do you work for a Member of Congress, Government Agency, Non-Profit, Private, or Civic Organization? (Please check appropriate box) *
If you work for a Member of Congress please write down their name and State or House District they represent. *
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If you work for a Federal, State, Regional or Tribal, or Local Government department or agency please state the name of the agency and the city and state where it is located. *
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If you work for non-profit, private, or civic organization please state the name, city, and state where it is located. *