Membership Application

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Name *

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Date of Birth *

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Gender Pronouns *

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Occupation (if applicable)

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School (if applicable)

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Phone *

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Email Address *

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Address *

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Highest Level of Education Completed *

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Do you have experience working with youth? *

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Organizations you have worked with or are currently involved in: *

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How would you identify yourself politically? *

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Do you have any unique/special skills? *

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Please explain your interest in joining KmB. *

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