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1. What is your name? 
Please include your first and last name
(Required.)

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2. Please select the improvements below that apply to you: (Required.)

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3. Where are you working or going to school? (Required.)

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4. When did you start?
If you are not sure of the exact date, please estimate a start date.
(Required.)

Date

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5. How much are you currently earning per paycheck?
If you aren't sure of an exact amount, please estimate as best you can.
(Required.)

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6. Do you get paid every week or every two weeks?

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7. Are you working or attending school full time or part time?

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8. Is there anything else you would like to share with your teacher about your new opportunity? 

T