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2012-2013 Demographics Form
This information is necessary for Ms. Kelly to maintain her records and provide written communication with your administration.
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Name
*
Your answer
Chapter
*
Your answer
School Information
School Name
*
Your answer
Address
*
Your answer
City
*
Your answer
Zip
*
Your answer
School Phone
*
Your answer
School Fax
*
Your answer
Principal
*
Your answer
CTE Director
*
Your answer
Director of Schools
*
Your answer
Chapter Information
Ag Department Phone Number
*
Your answer
Ag Department Fax Number
*
Your answer
Ag Department/FFA Chapter Website
*
Your answer
Personal Information
Home Address
*
Your answer
City
*
Your answer
Zip
*
Your answer
Home Phone
*
Your answer
Cell Phone
*
Your answer
Email Address
*
(Please put the email address that you check the most often)
Your answer
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