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* 1. My current grade is

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* 2. I attend the following school

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* 3. Select any of the following  teen community events that you would consider participating in

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* 4. I am available the following evenings/days to participate

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* 5. With regard to teen night outs, I prefer the following activities

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* 6. Please select 4 activities you would participate in

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* 7. I am in need of community service hours

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* 8. If my parent is willing to assist with teen activities within the City of DuPont their email is

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* 9. Comments

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* 10. If you would like to receive emails about upcoming teen events please leave your email below

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