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Name OF PERSON APPLYING*
Email Address*
Phone Number
Union/club/Program Name*
Program Website*
City*
State*
are you a regional select team or club?*
Yes
No
Is your program or club registered with USA Rugby?*
Yes
No
Are all of your players, coaches registered with USA Rugby?*
Yes
No
What are your goals in becoming a member Of the XV Series?*
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