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* 1. STUDENT LEGAL NAME

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* 2. GENDER

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* 3. DATE OF BIRTH

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* 4. CURRENT TEAMMATES CHAPTER (Community or School District)?

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* 5. POST-SECONDARY SCHOOL you are attending or plan to attend 

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* 6. INTENDED YEAR IN SCHOOL for Fall 2020

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* 7. INTENDED MAJOR

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* 8. CURRENT ASPIRATIONS/FUTURE PLANS

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* 9. CELL PHONE NUMBER

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* 10. PERSONAL E-MAIL ADDRESS

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* 11. SCHOOL E-MAIL ADDRESS

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* 12. PARENT/GUARDIAN FULL NAME

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* 13. PARENT/GUARDIAN CELL PHONE NUMBER

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* 14. PARENT/GUARDIAN E-MAIL ADDRESS

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* 15. HOME ADDRESS, CITY, STATE, ZIP CODE

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