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District/Zone Request for CEP

To request the Club Excellence Process for your district or zone, please complete the below form:

* Required

Fill out the 4 fields below then click the "Add" button. You may add as many Clubs as you need.

*Club Name:

*Club Number:

*District:

*Number of Participants:

When you have completed adding all Clubs, fill out the rest of the form and click the "Submit" button.

*Name:

*Phone:

*E-mail:

Please provide a street address for materials shipped by courier

*Address:

*City:

State/Province:

Zip/Postal Code:

*Country:

*Name:

*Position/Title:

*Phone:

*E-mail:

Please Enter This Security Code Below:	BL2CWCH
You must enter code to Submit this form ->

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