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* 1. First name , Last name, Email address, Phone number, date of birth, Gender, Street Address?

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* 4. Cumulative Grade Point Average (GPA):   (On a 4.0 scale) 

*There is no GPA requirement for this scholarship

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* 5. Will you be full time or part time student?

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* 6. What major are you choosing?

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* 7. Do you have reliable transportation?

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* 8. What is your current job if employed? Write n/a if not employed.

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* 9. Any extra curriculars? If none, why?

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* 10. What does a successful life look like? Do not write more than a paragraph.

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