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Last Name *

E-mail *

Pirate Name (Don't have one yet? Say "N/A") *

Who you are staying with, If Open Camping say "N/A" *

Land Grant - are these land grant hours? (Not sure? Click No) Yes
No

Who gets credit for your Land Grant hours? (N/A if not Land Grant Hours)

Did you check to make sure Autofill hasn't entered garbage? * yes

Pronouns/Preferred Name

Answer the following: 7 + 1 = __ *

* = required

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