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Youth Ambassador Application
Be the positive change the world needs. Become an Akshaya Patra Youth Ambassador today!
First name
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Last name
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Email
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Your email is important for communication from our team and for updates. Please enter your active email address.
Date of Birth
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Date Format: MM slash DD slash YYYY
Grade
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Full Address
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School name
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Clubs you currently participate in
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Preferred chapter
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Preferred chapter
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