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Apply Boys and Girls Club 2011-2023
___________________________________________
State: __________________ Zip: __________________Current Age: ___________ Date of Birth: _______________________
How did you learn about the Boys & Girls Club of the Bemidji Area? Please check all that apply.
Walk-In
Friend/Relative
Club Employee
High School: ______________________________________
United Way
College: _______________________________________
Media (Newspaper, Radio, T.V., Internet, etc.): __________________________
Other:...
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