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* 1. Enter your contact information:

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* 3. If a single mom, how long have you been a single mom?

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* 4. How many children do you have, and what are their ages?

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* 5. How many of your children currently live with you?

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* 7. If employed, how many hours per week do you work (on average)?

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* 10. Please describe why you want to start or return to college.

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