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12in12

12 in 12 Reading-Career Ambassador Registration

Become a reading-career ambassador by filling out the form below.

First Name

A value is required.

Last Name

A value is required.

Email Address

A value is required.Invalid format.

Phone number

A value is required.Invalid format.

Are you registering as a business or an individual

Business Individual

Home Address (if you are registering as an individual):

,

Business Address (if you are registering as a business):

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Name of People I want to recommend (please seperate names by comma AND include yourself as well):

Join Us Here

Yes- I want my $1,000,000.00 Book Mark!

If you are under 13 years old, please get your parent's permission before joining.

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