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Name:
Address:
Phone Number:
Grade: 9 10 11 12 Email:
List two teacher references:
Teacher #1:
Teacher #2:
Answer the following questions:
#1: What type of volunteer work would you like to do most?
#2: Why do you want to join Anchor Club?
#3: Were you a member of Anchor Club last year?
Yes No
#4. If so, did you complete your required service hours each month?