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Questions marked with an * are required Exit Survey
 
 
* 1. How many people currently reside in your house?
   
 
 
 
* 2. What countries are you currently a citizen of?
   
 
 
 
3. What is your date of birth?
 
 
 
* 4. What is your gender?
 
Male
 
Female
 
 
 
* 5. What country were you born in?
   
 
 
 
* 6. What is your name and job within the Federation? List if multiple.