Membership Application
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First Name
Last Name
Pronouns
Select
He / Him / His
She / Her / Hers
They / Them / Theirs
Community Selection
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Gay Male
Lesbian
Bi-Sexual Male
Bi-Sexual Female
Queer
Transgender M to F
Transgender F to M
Questioning
Asexual
Pansexual
Nonbinary
Intersex
Ally
Home City
Home State
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AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
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IA
ID
IL
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KS
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MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
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OH
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OR
PA
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TN
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WA
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Birth Month
Select
January
February
March
April
May
June
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Birth Day
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01
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03
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31
Age group
Select
18 - 25
26 - 35
36 - 45
46 - 55
56 - 65
over 66
Email Address
Receive Constant Contact Email
Yes
No
Phone Number
Reviewed Doctrine
Yes
No
Accept Doctrine
Yes
No
