REGISTRATION FORM

REGISTRATION FORM
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

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COLUSA COUNTYEnrollment Fee
$53.00



FRESNO COUNTYEnrollment Fee
$70.00



OUT OF COUNTYEnrollment Fee
$70.00



SAN JOAQUIN COUNTYEnrollment Fee
$48.00



YOLO COUNTYEnrollment Fee
$63.00



Total

$0.00

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