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* 1. Are you a Permanent Resident or Landed Immigrant?

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* 2. What year did you enter Canada? 

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* 3. First Name

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* 4. Last Name

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* 5. Age

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* 6. Grade and School?

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* 7. Phone Number

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* 8. Email

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* 9. Why do you want to join the program?

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* 10. How did you hear about this program?

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