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CSP Scholar Contact Information
Last Name
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First Name
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College you are currently attending
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College Student ID Number
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Birthday
MM
/
DD
/
YYYY
Expected Graduation Date
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Permanent Home Mailing Address
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Mailing address for the place you'll be living at college this year
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Preferred Email Address
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Preferred phone number for voice messages
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Preferred phone number for text messages (if different from above)
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Name and phone number of someone who will always know how to contact you
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If you are on social media, tell us how to connect with you! (Facebook, Twitter, Instagram, Snapchat)
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Is there anything else you'd like us to know?
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