All information will be kept private! 

PLEASE NOTE: This program is for Massachusetts residents only.

The following information is required to begin the application process. A FDA Adult Compliance Officer or an associate from the Tobacco Undercover program will be contacting you with the next steps of the application process.

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* 1. First name ONLY*

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* 2. Pronouns

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* 3. Age - Only youth between ages 16 - 20 are eligible to work for the program (if you will be 16 in 3 months or less, you may be considered). *

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* 4. Will you turn 21 in 6 months or less?

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* 5. Do you currently live in or attend school in Massachusetts? 

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* 6. Please list an email to send the application to: *

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* 7. What phone number can we reach you at? *

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* 8. What city/town do you live and/or go to school in (MASSACHUSETTS RESIDENTS ONLY)? *

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* 9. When are you available to work? Check all that apply.

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* 10. Is there anything else you'd like to share about your availability? 

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* 11. How did you hear about this position?

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