Readers Are Leaders - Intake Form
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First Name (Child's) *
Last Name
Age *
Gender *
Where do you live?  (City, Country) *
E-mail (Parent's) *
Who referred you? (full name and/or e-mail of the person who told you about us, you might both win a prize!)
What's Your Favourite Book? *
Why Do You Want To Join This Book Club? *
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