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2. Your name*
3. Your email*
5. Reason for Contact*
   -- Select One --Information RequestGeneral ComplaintAmericans with Disabilities (ADA) ComplaintComplimentSuggestionWebsite CommentOther
7. Rate the FACT program

   1. Poor
   2. Fair
   3. Good
   4. Very Good
   5. Excellent
8. Number of days you normally ride each week*

   1. None
   2. Daily
   3. 2 -3 Times
   4. 3 - 4 Times
10. Rate our website:

    1. Excellent
    2. Fair
    3. Good
    4. Poor
    5. Very Good
12. Your Comments*
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