Star of the North Resident Application
If you are interested in more information before or after submitting this application, please call 218-461-0564.
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Email *
Name *
Phone Number *
Can we text you at this number? *
Required
Current Address *
Birthday: *
MM
/
DD
/
YYYY
Current Age: *
Are you a resident of Northeastern MN or Northwestern WI? *
Other Contact Name and how are they associated to you (parent, spouse, etc) *
Other Contact number &/or email: *
Marital Status? *
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