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| Middle Initial: | Optional | |
| Last Name: | Required | |
| E-Mail Address: | Required | |
| Homepage URL: | Required | |
| Date of Birth: | Required | |
| Sex: | Male Female | Required |
| City: | Required | |
| State/Province: | Required | |
| Country: | Required | |
| Phone Number: | Optional | |
| Occupation: | Optional | |
| How did you find us? |
| Optional |
| References/Other Organizations: | Required | |
| Brief Explanation of why you are interested in joining: | Required | |
| How do you feel about people owning wolfdogs?: | Required | |
| Comments: | Optional | |