L-TALC Membership Application - Interest Form
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Please enter your full name. *
Please enter your preferred name (if applicable).
Please select your gender. *
Please select your ethnicity. (Check all that apply) *
Please provide your preferred email address. *
Please provide your BANNER ID (Enter "N/A" if you do not have a BANNER ID) *
Are you interested in learning more about our informal learning clubs?
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What kind of school are you currently attending?
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