SD Fixit Clinic Application
Please fill out the entire form if you are interested in volunteering with the SD Fixit Clinic
Email address *
Full Name (First and Last) *
Your answer
Street Address *
Your answer
City *
Your answer
Zipcode *
Your answer
Email Address *
Your answer
Phone *
Please indicate whether this is a cell phone or landline.
Your answer
Age *
Tell us a little bit more about yourself. *
Your answer
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