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Name: Address: City: State: Telephone: (Home) (Work) Date of Birth: Infantry: Zip: Email address: Civilian: Other: Please describe the impression you would like to do: Dues: Family$20./yr. Individual$10./yr.
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How to fill out 7th md application color:

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Individuals who are applying for the 7th md program at a specific institution or organization.
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The 7th md application color is blue.
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