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Core Membership Questionnaire Spring 2019
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* Indicates required question
Personal Information
1.
Age:
*
18-20
21-25
26-30
31-35
36 Plus
2. What is your current living arrangement?
*
At home with parent(s)/family
In a group home
At Wascana Rehabilitation Centre
Living independently
Other:
3.
Who is providing support in filling out this survey?
*
Myself
My companion
My parent
My careworker
Astonished! staff/volunteer
Friend
Other:
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