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* 1. Please enter your name

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* 2. What is your age?

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* 3. At what email address would you like to be contacted?   *We will only use this email to send info about events

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* 4. In what ZIP code do you live?

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* 5. What type of events are you interested in with the Ole Miss Club?

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* 6. What areas should we host events at?

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* 7. What is your connection to Ole Miss?

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