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| First Name |
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| Last Name |
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| Screen Name |
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| Address 1 |
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| Address 2 |
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| City |
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| State |
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| Zip Code |
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| Email |
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| Gender |
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| Year of Birth |
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| Children |
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Enter Birth Date
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| Household Income |
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| Employment |
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| Marital Status |
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| Highest Education Level |
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| Race |
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How much have you relied on the following for support, ideas and information as you’ve been raising your children?
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| Family Members |
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| Friends |
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| Books & Magazines |
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| Websites |
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| How strongly agree or disagree with the following statements? |
| I love to tell people something new I've learned |
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| People I am closest to ask my opinion and follow my advice |
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| I'm not that interested in what other people think about products or businesses |
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| People would say that I am a "natural talker" who enjoys talking with many people about many things |
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