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First Name:

Last Name:

Email:

Phone Number

Date of Submission:

Are you a part of the Republican party?

Yes

Are you going to vote in the upcoming primary elections?

Yes No Most Likely Yes Most Likely No I'm not sure

Which candidate are you going to vote for

Nikki Haley Donald Trump Joe Biden

Where have you heard of Nikki Haley?

What should Nikki Haley do to get your support?