Student Data - 2018

First name of student:

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* 1. First name of student:

Last name of student:

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* 2. Last name of student:

Student's parish (parish name and city):

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* 3. Student's parish (parish name and city):

Student's high school (school name and city):

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* 4. Student's high school (school name and city):

Student's e-mail address (non-school address, i.e., @gmail, @yahoo, @me, etc.):

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* 5. Student's e-mail address (non-school address, i.e., @gmail, @yahoo, @me, etc.):

Student's cell phone number (including area code):

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* 6. Student's cell phone number (including area code):

Student's college or university of choice: 

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* 7. Student's college or university of choice: 

City/town where university or college is located: 

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* 8. City/town where university or college is located: 

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