Please provide some contact details & we will be in touch via email shortly

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your email address?

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* 4. What is your phone number?

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* 5. What suburb do you live in?

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* 6. What is your postcode?

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* 7. Country Opinions is working on booking participants for this project. Country Opinions will send you an email in the coming weeks, keep an eye out in your inbox and/or junk mail for an email from georgina@countryopinions.com.au. This will be completely safe for you to open, there will be a further survey link in this email asking for more detailed information - it's just to ensure we get a good representation of people from the Endeavour Energy supply areas for the project. Are you ok with this. 

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* 8. Privacy Policy: we take your personal data protection seriously and we manage all personal data in accordance with the Data Protection legislation Australia. The details you have provided will need to be provided to SEC Newgate, an independent research company, conducting the project on behalf of Endeavour Energy.  We will also need to provide your details to Country Opinions who will are responsible for recruitment of participants for this project.  Do you give permission for your details to be provided to SEC Newgate & Country Opinions?

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