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* 1. Name

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* 3. Phone

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* 4. Address

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* 5. Date of Birth

Date

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* 6. Name of High School

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* 7. Year Graduated High School

Date

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* 8. This application is for enrollment as:

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* 9. What is your planned major?

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* 10. Have you participated in any organization/clubs in your school?

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* 11. Are you a United States Citizen?

T