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Screener Form
Complete this short form to see if you qualify.
1
Contact Information
Demographics & Preferences
Page 1: Contact Information
First Name
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Email Address
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Your Mobile Number
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What city or town do you currently live in?
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Your Home Zip Code
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By checking this box, I assert that I have read the information above and confirm that I identify as Black/African American, am at least 21 years old, and live in Metro Denver, Aurora, or Colorado Springs.
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