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* 1. Name (First, Last)

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* 2. E-Mail Address

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* 3. Phone Number

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* 4. Passport Number - (4-Digit Birthday; i.e. October 12 = 1012)

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* 5. How often do you attend African Dance and/or Drum classes in the Metro Atlanta Area

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* 6. What organization is your home base for African Dance and/or Drum in the Metro Atlanta Area

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