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* 1. Current School/Occupation

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* 2. Year of Birth (i.e. 1998)

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* 3. Sex

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* 4. Where will you be living in 2017?

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* 5. Are you interested in playing rugby in 2017?

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* 6. If no, why?

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* 7. If yes, then which day would you prefer to play on?

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* 8. Which club would be your first preference?

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* 9. Preferred Contact Method

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* 10. Email Address (optional)

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