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* 1. What is your first and last name?

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* 2. What is your Date Of Birth?

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* 3. What state do you reside in?

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* 4. What ZIP code or Postal code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 5. Email address:

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* 6. Phone Number:

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* 7. What class are you planning on going to race?

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* 8. How are you paying for the Rookie Program?

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