Application

Legacy Club Application

Thank you so much for your interest, we look forward to welcoming you into our LEGACY family!

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Select Chapter *

Name *

First

Last

Address *

Line 1

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City

State

Zip Code

Country

Email *

Phone Number *

Grade *

Overall Grade Average *

Tell us more about yourself *

School *

Will you be able to pay the $125 membership fee? *

Do you have the time required for membership? *

Name *

First

Last

Phone Number *

Email *

Do you have your parents support for membership? *

Comment *

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