* 1. Student First Name

* 2. Student Last Name

* 6. Student Email - Use this format - xxxxx@xxxx.xxx

* 7. Mailing Address - Include Apartment # - Format Example: 453 W. James Street

* 8. City

* 9. Zip Code

* 10. Student Cell Phone Number - Please use this format (XXX) XXX-XXXX

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