Individual Registration


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General Information
*  First Name: 
*  Last Name: 
Country:
USA 
  Address 1:
 
Address 2:
City:
 
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*  Birthdate: 
   
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Daytime Phone
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Have you ever played in the APA before?
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City: 
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Format Played: 
Highest 8-Ball Skill Level: 
Highest 9-Ball Skill Level: 
Have you ever played in a non-APA pool league?
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League Name: 
Skill Level (Rank): 
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