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BU Twin Project
Child Cognition Lab
Language & Learning Lab
Contact Information
Parent Name 1:
Parent Name 2:
Street Address:
City: State: MA AL AK AR AZ CA CO CT DE DC FL GA HI IA ID IL IN KS KY LA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code:
Contact Phone 1: CHOOSE TYPE Home phone Cell phone Work phone CHOOSE PARENT Parent 1 Parent 2
Contact Phone 2: CHOOSE TYPE Home phone Cell phone Work phone CHOOSE PARENT Parent 1 Parent 2
Email Address:
What is the best way to contact you?
How? CHOOSE ONE Email Phone - Home Phone - Cell Phone - Work US Mail
When? (e.g., mornings, after 3 PM, etc.)
Do you have any specific comments or questions?
Child Information
Male Female
Yes No
What languages does your child hear at home other than English?
How often?
<10% 25% 50% (bilingual) 75% 100% (child never hears English)
How did you hear about us?
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