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User Information

Please tell us a little about yourself! All users must be between the ages of 13 and 19, and must be current or former military dependents.

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* 1. First Name

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* 2. Last Name

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* 3. Current Age

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* 4. Email Address

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* 5. What is your Discord user name and #?

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* 6. Please briefly describe your military affiliation.

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* 7. Where are you currently stationed/located?

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* 8. What is one thing about military life that you enjoy and one thing that you could do without?  

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* 9. By checking this box, I certify that I have read and agree to abide by the Bloom Community Code of Conduct and accept the Terms of Use.

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