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Junior Board Sign Up

Please fill out the form below to submit your application. (Takes about 3 to 5 minutes to complete.) You must be 13 years old or older to fill out this form.

First Name
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Last Name
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Nickname
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Birth DateMN/DY/YEAR
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Address
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City
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Zip
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Phone
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Facebook Screen Name
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Twitter Handle
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Additional Social Media Apps You Use
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Current School
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Mother / Guardian Name
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Mother / Guardian Phone
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Father / Guardian Name
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Father / Guardian Phone
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If Ranken Jordan Employee, School or OtherPlease be Specific
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Skills / Hobbies / Interests
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