In Youth We Trust Member Application
First Name
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Last Name
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Preferred Name
What should we call you? Kathryn? Kate? Katie? Kat? KT?
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Gender
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Age
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Birthdate
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High School
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Graduation Year
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Home Address
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City
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State
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Zip
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Email
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Preferred Phone
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This phone is:
Other Phone
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This phone is:
Do you:
Check all that apply.
Required
The best way to reach me is:
T-shirt size
Parent/Guardian Name(s)
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Parent/Guardian Phone(s):
Include home and cell for all, if available.
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Parent/Guardian Email(s):
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Who should be the primary parent/guardian contact?
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