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Join Our Club

Want to join our club? Well, we make it easy! Just fill out this form with all your information and someone will contact you to fill you in on the exciting details of being a Junior Civitan! For more questions, email Paul Vetrone and he'll get right back to you!

First Name
Last Name
Street Address
Phone # (Please include area code)
Age
Email Address
Father's Name
Mother's Name
Allergies
Health Card Number
School

* Don't live in Burlington? Contact Paul Vetrone to find a club near you!