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First Name: *
Last Name: *
School / Educational Organization: *
School / Educational Organization Address:
City / State / Zip:
What grade levels do you teach? *



Would your students be interested in volunteer opportunities?(Such as registration support for Middle School competitions.)
Which programs are you interested in? *




Would you like to be added to our newsletter?
T-Shirt Size
Do you have any dietary concerns?
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Birthday

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Other Comments: