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* 1. What's your name?

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* 2. What's your email?

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* 3. How old are you?

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* 4. What Youth MOVE Chapter are you a part of OR what state do you live in?

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* 5. Upload your image

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* 6. Were you not able to add a caption to the image yourself? No problem. Tell us your caption and we'll do the Photoshop for you.

What's your caption?

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* 7. Tell us what inspired your meme?

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* 8. Why is this message important to you? 

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* 9. By submitting, you authorize Youth MOVE National to use the information you provided above. Do you agree?

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