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A.M.O.B. Girl Interest Form
This form needs to be filled out in its entirety.
* Indicates required question
Email
*
Record my email address with my response
Full Name
*
Your answer
Age
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Address
*
Your answer
Name of School
*
Your answer
Grade
*
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
High School
Adult
Required
I am interested in:
*
Mentoring (6-24)
After School Care (6-12)
Drop In Saturday (10-18)
A.M.O.B. Girls Work Too (13-24)
Independent Living (17-24)
Group Therapy (12-24)
Life Study Skill (12-24)
Summer Camp (6-12)
Required
Shirt Size
*
Youth Size S
Youth Size M
Youth Size L
Adult S
Adult M
Adult L
Adult XL
Adult 2X
Adult 3X
Required
I am willing to commit to the entire program.
*
Yes
No
Other-
I am able to pay a monthly membership fee?
*
Yes
No, but I still want to be a part of the program
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