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Student Information

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Instructions: Please fill out the requested information as far as possible. If your information changes during the term, please update the form.

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Question 1   Fill in the Blank
  Question: What is your local mailing address?
 
     

 
Question 2   Fill in the Blank
  Question: What is (are) your local telephone number(s)?
 
     

 
Question 3   Fill in the Blank
  Question: What is your preferred email address?
 
     

 
Question 4   Fill in the Blank
  Question: What is (are) your expected major(s)?
 
     

 
Question 5   Fill in the Blank
  Question: What is (are) your expected minor(s)?
 
     

 
Question 6   Fill in the Blank
  Question: (Optional) When is your birthday?