2019 Perspective Member of the M.H.S. Mighty Black & Gold
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Please Check all that Apply
Student (You) Information
First Name *
Middle Name
Last Name *
Current Grade Level *
Birth Month *
Birth Day *
Birth Year *
Sex *
Primary Instrument *
Secondary Instrument
Home Street Address *
City *
State *
Zip *
Home Phone Number (xxx)xxx-xxx
Cell Phone Number (xxx)xxx-xxxx
Email Address *
T-Shirt Size *
Middle School (If other, please specify to the right of Other) *
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