Open House Registration Aug 1st and 3rd

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1. Name (First and Last name):

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2. Home Address:

Street

Street

City, State, zip code

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3. Home Phone Number:

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4. Email Address:

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5. Cell Phone Number:

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6. Check one:

Returning Student

New Student

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7. Have you completed the Free Application for Federal Student Aid (FAFSA)?

Yes

No

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8. Interested Program of Study:

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9. T-Shirt Size: