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SkillsUSA Membership
First Name: __________________________________________________
Last Name: _________________________________________________
Birthdate: ___________________________________________________
Gender (circle): Female Male
Graduation Year: _____________________________________________
Ethnicity (circle): Black/African American Hispanic/Latino/Spanish White/Caucasian
Asian American Indian/Alaska Native Native Hawaiian/other Pacific Islander
Multicultural Other
Email: ______________________________________________________
Address: ____________________________________________________
Address Line 2: _______________________________________________
City: ____________________________ ST: ______ ZIP: _____________
Home #: ____________________________________________________
Work #: _____________________________________________________
SkillsUSA Membership
First Name: __________________________________________________
Last Name: _________________________________________________
Birthdate: ___________________________________________________
Gender (circle): Female Male
Graduation Year: _____________________________________________
Ethnicity (circle): Black/African American Hispanic/Latino/Spanish White/Caucasian
Asian American Indian/Alaska Native Native Hawaiian/other Pacific Islander
Multicultural Other
Email: ______________________________________________________
Address: ____________________________________________________
Address Line 2: _______________________________________________
City: ____________________________ ST: ______ ZIP: _____________
Home #: ____________________________________________________
Work #: _____________________________________________________
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