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Name
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Date
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Address
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Email Address
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City, State, and Zip
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Home Phone
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Other Phone
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1. Why did you join the club?
A) Activities
B) Education
C) Socializing
D) Environmental/Conservation Concerns
E) Other (Please be specific)
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2. What can you contribute to the club?
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3. Would you be willing to share your experiences and/or skills with the club?
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4. Are you willing to serve as a board member or club officer?
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