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What is your gender identity?
How old are you?
Under 18
18-24 years old
25-34 years old
35-44 years old
45-54 years old
55-64 years old
65 +
What is your ethnic background?
What county do you live in?
What is your level of education?
What is your martial status?
What is your employment status?
What is your annual household income?
How many dependents live in your home?

4290 S. School Ave,

Fayetteville, AR 72701

479-521-4947

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