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SD Fixit Clinic Application
Please fill out the entire form if you are interested in volunteering with the SD Fixit Clinic
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Email
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Your email
Full Name (First and Last)
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Your answer
Street Address
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Your answer
City
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Your answer
Zipcode
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Your answer
Phone
*
Please indicate whether this is a cell phone or landline.
Your answer
Age
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Under 17 years old
Over 17 years old
Tell us a little bit more about yourself.
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Your answer
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