First Name:

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* 1. First Name:

Middle Initial:

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* 2. Middle Initial:

Last Name:

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* 3. Last Name:

High School:

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* 4. High School:

Number Attending:

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* 5. Number Attending:

Street Address:

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* 6. Street Address:

City:

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* 7. City:

State:

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* 8. State:

Zip Code:

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* 9. Zip Code:

Phone Number:

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* 10. Phone Number:

Email Address:

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* 11. Email Address:

Please check one:

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* 12. Please check one:

Rust College Spring 2018 Preview Day:

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* 13. Rust College Spring 2018 Preview Day:

Which division are you interested in: Education:

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* 14. Which division are you interested in: Education:

Are you currently a:

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* 15. Are you currently a:

Anticipated Athletic Interests:

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* 16. Anticipated Athletic Interests:

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