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* 1. Parent/Guardian name?

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* 2. Students name

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* 3. Email

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* 4. Phone number

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* 5. What is your GPA?

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* 6. What is your total household income?

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* 7. How many people currently live in your household?

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* 8. Other extracurricular activities?

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* 9. Tell us about yourself?

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