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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. College

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* 5. Year in school

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* 6. If you have an internship this summer, add your position (otherwise, type N/A):

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* 7. If you have an internship this summer, add the business name (otherwise, type N/A):

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* 8. Mailing Address (for Certificate of Completion):

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