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* 1. First & Last Name:

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* 2. E-mail Address:

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* 3. Please select one:

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* 4. If you are participating in this event for service-learning, please list course number and professor/instructor name. 

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* 5. Please note that on-site service projects involve light to moderate physical activity such as, weeding, painting, etc. Are there any special accommodations/ modifications you require? If yes, please explain:

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