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LYO 2023-2024 Recommitment
This application is to recommit to LYO for the 2023-2024
school year.
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* Indicates required question
Last name
*
Your answer
First name
*
Your answer
Nickname (If there is another name you prefer to be called, please enter it here. If you enter a nickname, it is the name that will appear on your nametag at events.)
Your answer
Grade in the 2023-2024 school year
*
9th
10th
11th
12th
Congregation name
*
Your answer
Congregation city, state
*
Your answer
Home address
*
Your answer
Email
*
Your answer
Home phone number (If you do not have a home phone, please enter your cell phone number)
*
Your answer
Cell phone number (If you do not have a cell phone, please enter your home phone number again)
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
T-shirt size
*
S
M
L
XL
2XL
3XL
School name
Your answer
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