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Rural Week 2020 - Student Registration

Personal Information

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* 1. Please complete the following:

Only include your university provided email address please.

First Name:

Last Name:

Email Address: **

Cell Number:

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* 2. Gender

Male

Female

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* 3. Where did you grow up?

Urban Manitoba

Rural Manitoba

Northern Manitoba

I am not from Manitoba

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* 4. Please specify the community / city that you grew up in.