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Registration Number

Delegate's Last Name

Delegate's First Name

Delegate's Middle Initial

Gender

Delegate's Nickname

Delegate's Street Address

Apt/Unit/Suite

Delegate's City

Delegate's State

Delegate's Zip Code

Delegate's Cell Phone

Delegate's Home Phone

Delegate's Email

Repeat Delegate's Email

Delegate's Date of Birth

High School Delegate Attends

Sponsoring District Number

Sponsoring Post Number

Sponsoring Post Name/City

Area

Parent/Guardian's First Name

Parent/Guardian's Last Name

Parent/Guardian's Mailing Address

Parent/Guardian's City

Parent/Guardian's State

Parent/Guardian's Zip

Parent/Guardian's Email

Parent/Guardian's Cell Phone

Parent/Guardian's Home Phone

Devices

Delegate's Shirt Size

Is anyone in your family currently Active Duty? If so, relationship to Active Duty member...

Password

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