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  1. (for verification purposes only pursuant to 18 U.S.C. §§ 2256 et seq.) *
  2. Where did you grow up?
  3. Pease list show titles and the dates that you have appeared.

  4. Describe your physical fitness level, your preferred forms of physical fitness and how often you participate in physical activity. Include the most challenging thing you've accomplished, if relevant.
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  6. If so, please explain.
  7. Type "NA" if you do not have a passport.
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