ΣΑΕ - COLORADO CHI
POTENTIAL NEW MEMBER QUESTIONNAIRE
First Name
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Last Name
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Preferred Name
If other than name above
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Birthday:
MM
/
DD
/
YYYY
Mobile Phone
(xxx) xxx-xxxx
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CU Boulder Email Address
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Mailing Address (Boulder)
Name of Dormitory or Address Off Camups
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Year
Major
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