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LA Fixit Clinic Volunteer Application
Please fill out the entire form if you are interested in volunteering with the Los Angeles Fixit Clinic
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Email
*
Your email
Full Name (First and Last)
*
Your answer
Street Address
*
Your answer
City
*
Your answer
Zipcode
*
Your answer
Phone
*
Please indicate whether this is a cell phone or landline.
Your answer
Age
*
Under 17 years old
Over 17 years old
If under 16 years old please provide the name of your guardian attending with you.
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Tell us a little bit more about yourself.
*
Your answer
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