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BTC Quickie Membership Form
Member/Teen Information
Member Name
*
First
Last
Member School
*
Brookline High School
Baker Elementary
Devotion Elementary
Driscoll Elementary
Heath Elementary
Lawrence Elementary
Lincoln Elementary
Pierce Elementary
Runkle Elementary
Beaver Country Day
Dexter Southfield
Meridian
Park School
Maimonides
Ivy Street School
New England Hebrew Academy
St. Mary of the Assumption
Torah Academy
Bay Cove Academy
Beacon Academy
Other School
Other School
*
*HIGH SCHOOL* Graduation Year
*
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
Date of Birth
*
Month
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Day
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31
Year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
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2009
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2003
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1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Gender
*
Female
Male
Other (please specify)
Other Gender
*
Member Email
*
Member Cell Phone
*
Parent Information
Parent Name
*
First
Last
Parent Email
*
Parent Cell Phone
*
Membership Card
Membership Card ID
*