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Home
About Us
Our Mission
Meet our Founder
Get Involved
Programs
Our Voice Registration Form
MDC Inc. Volunteer Application
Betty L. Gooch Scholarship Fund
Our Donors & Sponsor
Upcoming Events
Just Me! Shop
Contact
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Our Voice Registration Form
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Participants Name
*
First
Last
Date of Birth
*
Address
*
City, State, Zip
*
Home Phone #
*
Participants Cell #
*
Participants Email
*
School Attending
*
Grade
*
Current GPA
*
Extracirricular Activities/Groups
*
Parent/Guardian Name
*
First
Last
Cell Phone #
*
Parents Email
*
Registration Type
*
Select One
Returning Member $35
New Member $50
Registration type and fee
Parents Electronic Signature
*
By signing, I give MDC Inc. permission to bill me for the above registration fee.
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