1.

* 1. Name:

* 2. Address (including city, state, and zip):

* 3. Telephone:

* 4. Personal e-mail address:

* 6. Degree(s)

* 7. Academic work beyond baccalaureate:

* 8. Present occupation:

* 9. Influential LVC teachers? Why?

* 10. Unforgettable LVC experience:

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