All information will be kept private! 

PLEASE NOTE: This program is for Massachusetts residents only.

The following information is required to begin the application process. A FDA Adult Compliance Officer or an associate from the Tobacco Undercover program will be contacting you with the next steps of the application process.

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* 1. First name ONLY*

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* 2. Age - Only youth between ages 16 - 20 are eligible to work for the program (if you will be 16 in 3 months or less, you may be considered). *

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* 3. Please list an email to send the application to: *

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* 4. What phone number can we reach you at? *

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* 5. What city/town do you live and/or go to school in (MASSACHUSETTS RESIDENTS ONLY)? *

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