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CYEA Champion Gardener Registration Form
Join Us and Cultivate Change: Register Today to Become a Champion Gardener!"
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Age
Your answer
Birthday
*
MM
/
DD
/
YYYY
Contact Phone Number
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Phone Number
*
Your answer
Email Address
*
Your answer
Primary Address
*
Your answer
What positions are you interested in?
Jr Executive
Jr Chef & Event Coordinator
Jr Civil Engineer
Jr Finance Manager
Jr Farmer
Jr Market Manager
Other:
Shirt Size
*
XS
S
M
L
XL
XXL
Please provide any medical or dietary restrictions you have:
*
Your answer
How did you hear about CYEA?
*
Facebook
Email
School Official
OooWee Fresh! Market Cafe
Other:
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