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S.T.A.C. CAMPS
SCHOLARSHIP REGISTRATION FORM


Scholarship Registration Form
* - A required field
First Name*
Last Name*
Address1*
Address2
City*
State
Zip/Postal Code
Province (Outside of the U.S.)
Phone*
E-mail*
Participant's Name
School/Organization Name
Age
Parent/Guardian Name
Emergency Phone
T-Shirt Size
Camp



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