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Learn More About our Program
First name
Last name
Birthday
Month
Where do you live?
*
McKinley County
Other
Are you a parent, guardian or caregiver to a child five years old or younger?
*
Yes
No
Are you currently pregnant?
*
Yes
No
What is the best way for us to contact you?
*
Phone Call
Text Message
What is your phone number?
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What language do you prefer?
*
English
Spanish
Navajo
Other
How did you hear about Avenues?
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