Is this a cell phone capable of receiving text messages? *
Street address *
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City, state *
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Zip code *
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Mailing address (if different from above)
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Mailing city, state (if different from above)
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Mailing zip code (if different from above)
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If you will be a college student living on or near campus during the fall soccer season please select your educational institution, otherwise please select N/A. *