20/21 JA Career Series Pre-Program Survey (EI)

Tell Us about You

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1. What are the first 3 letters of your last name?

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2. When is your birthday?

	Month	Date
Month/Date	Month/Date Month menu	Month/Date Date menu

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3. What is your teacher's last name?

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4. What grade are you in?

6th

7th

8th

Other (please specify)

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5. What school do you attend?