1. What is your preferred first name?

2. What is your preferred middle name?

3. What is your preferred last name?

4. Please give us your preferred pronunciation of your name.

5. Full name for certificate?

6. Which of the "Cs" do you attend?

7. Major(s)?

8. Minor(s)?

9. What is your favorite thing about the QRC/Queer community in Claremont?

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